Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-ca10-91-07075/USCOURTS-ca10-91-07075-0/pdf.json

Nature of Suit Code: 863
Nature of Suit: Social Security - DIWC/DIWW (405(g))
Cause of Action: 

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FIL ~ D 

UNITED STATES COURT OF APPEALS 

FOR THE TENTH CIRCUIT 

United States Court of Ap,e~h 

Tenth c:-,,i-.: 

APR 3 0 1992 

CHRISTINA JAMES, 

Plaintiff-Appellant, 

v. 

LOUIS W. SULLIVAN, M.D., Secretary of 

Health and Human Services, 

Defendant-Appellee. 

) 

) 

) 

) 

ROBERT L. HOECKER 

Clerk 

) No. 91-7075 

) (D.C. No. CIV 90-316-S) 

) (E.D. Okla.) 

) 

) 

) 

ORDER AND JUDGMENT* 

Before EBEL, BARRETT, Circuit Judges, and KANE,** District Judge. 

**Honorable John L. Kane, Jr., Senior District Judge, United 

States District Court for the District of Colorado, sitting by 

designation. 

After examining the briefs and appellate record, this panel 

has determined unanimously that oral argument would not materially 

assist the determination of this appeal . See Fed. R. App. P . 

34(a); 10th Cir. R. 34.1.9. 

submitted without oral argument. 

* 

The case is therefore ordered 

This order and judgment has no precedential value and shall 

not be cited, or used by any court within the Tenth Circuit, 

except for purposes of establishing the doctrines of the law of 

the case, res judicata, or collateral estoppel. 10th Cir. R. 

36.3. 

Appellate Case: 91-7075 Document: 010110246218 Date Filed: 04/30/1992 Page: 1
Plaintiff Christina James appeals from an order of the 

district court affirming the Secretary's decision to deny her 

application for social security disability benefits. We affirm. 

In her application for benefits, James alleged that she was 

disabled due to hypertension, kidney problems, probable back 

cancer, and emotional problems. 1 At a hearing before the 

administrative law judge (ALJ), James alleged that she also had 

diabetes and arthritic problems with her hands, elbows, knees, and 

ankles. The ALJ found that James was not disabled at step four2 

because she could return to her past relevant work. 

On appeal, James argues that the ALJ's determination was not 

based on substantial evidence. In particular, she objects to the 

ALJ's findings numbers six and seven.

3 James states she was 

1 There is no evidence in the record that James has kidney 

problems or cancer nor does she argue that these impairments 

should be considered in determining whether she is disabled. 

2 For an explanation of the steps through which 

must proceed in making its determination of 

Williams v. Bowen, 844 F.2d 748, 750-52 (10th Cir. 

the Secretary 

disability, see 

1988). 

3 These findings state as follows: 

6. The claimant has the residual functional capacity 

to perform the exertional and nonexertional 

requirements of basic work activity except for 

lifting and carrying more than 50 pounds maximum 

and more than 25 pounds frequently. She is unable 

to perform types of work requiring very fine 

dexterity. The testimony and statements of 

impairments and pain of such severity to preclude 

any substantial gainful activity are unsupported by 

the medical evidence and are not credible. 

7. The claimant's past relevant work as a medication 

aide and nurse's aide, as performed in the national 

economy, do not r e quire the performance of the 

activities precluded by the above limitations. 

(continued on next page) 

2 

Appellate Case: 91-7075 Document: 010110246218 Date Filed: 04/30/1992 Page: 2
ineffectively represented by a paralegal and, therefore, under 

Dixon v. Heckler, 811 F.2d 506 (10th Cir. 1987), the ALJ was 

required to develop James' case for her. James argues that the 

ALJ did not fulfill this duty because he did not ask questions 

regarding her daily activities and medications beyond those asked 

by the paralegal. Finally, James argues that the record was not 

properly developed regarding her complaints of pain. 

"Our review of social security administration cases is 

usually quite limited. 'The Secretary's decision must be 

sustained if supported by substantial evidence. The reviewing 

court does not weigh the evidence and may not substitute its 

discretion for that of the agency.'" Sorenson v. Bowen, 888 F.2d 

706, 710-11 (10th Cir. 1989)(quoting Cagle v. Califano, 638 F.2d 

219, 220 (10th Cir. 198l)(citations omitted)). Substantial 

evidence is "'such relevant evidence as a reasonable mind might 

accept as adequate to support a conclusion.'" Richardson v. 

Perales, 402 U.S. 389, 401 (197l)(quoting Consolidated Edison Co. 

v. NLRB, 305 U.S. 197, 229 (1938)). 

James is now forty-nine years old. She has a ninth grade 

education and has obtained her GED and completed vocational 

training as a medication aide. She has worked both as a nurse's 

aide and a medication aide. James alleges disability s i nce 1984. 

The record shows that James has the following impairments: 

(1) hypertension; (2) diabetes; (3) r e flux esophagitis; (4) 

degenerative arthritis; and (5) back pain. James' hypertension 

(continued from previous page) 

Appellant's App., Vol. II, p. 35, De cision of ALJ, 

August 28, 1989. 

3 

Appellate Case: 91-7075 Document: 010110246218 Date Filed: 04/30/1992 Page: 3
has been successfully treated with medication, and there is no 

medical evidence of any end organ damage. James' diabetes has 

also apparently been treated successfully with diet only without 

any resulting disability. Therefore, these impairments cannot be 

the basis for any finding of disability. 

The symptoms James experiences associated with reflux 

esophagitis are relieved when she adheres to the prescribed course 

of treatment. The record shows James does not follow the 

prescribed medication regime, apparently due both to side effects 

she actually experiences and those she fears she will experience. 

Social Security regulations provide that claimants who fail, 

without good reason, to follow prescribed treatment will be denied 

benefits if it appears the treatment can restore the claimant's 

ability to work. 4 20 C.F.R. §§ 404.1530, 416.930; see also Teter 

v. Heckler, 775 F.2d 1104, 1107 (10th Cir. 1985). James' symptoms 

can be relieved. Her failure to follow the prescribed treatment 

cannot be excused. 5 Further, even untreated, nothing in the 

record indicates that this impairment is disabling. Therefore, 

4 Acceptable reasons for failure to follow prescribed treatment 

include: (1) the recommended treatment is contrary to the 

established tenets and teachings of the claimant's religion; (2) 

the treatment involves cataract surgery for one eye when there is 

already a significant impairment of vision in the other eye which 

is not subject to improvement through treatment; (3) the 

recommended treatment involves surgery which has previously been 

performed with unsuccessful results; (4) the treatment is very 

risky; or (5) the treatment involves amputation of an extremity or 

a major part of an extremity. 20 C. F.R. § 404.1530(c). None of 

these factors apply here. 

5 Disability benefits will 

is expected to restore a 

treatment was refused without 

substantial evidence. Teter, 

be denied if a prescribed treatment 

claimant's ability to work and the 

justifiable excuse, as supported by 

775 F.2d at 1107. 

4 

Appellate Case: 91-7075 Document: 010110246218 Date Filed: 04/30/1992 Page: 4
the ALJ correctly found that James is not disabled on the basis of 

this impairment. 

Degenerative arthritis is manifested mainly in James' hands 

by joint stiffness for two hours in the morning and episodic joint 

pain, swelling, and redness in various joints. Medical evidence 

shows that disease manifestations are mild with minimal impairment 

only in her hands. The ALJ determined that this impairment was 

not disabling but did consider it in finding number six where he 

held that James could not perform jobs requiring fine dexterity. 

James argues that her impairments, in combination with the 

pain she experiences, are disabling. Both reflux esophagitis and 

degenerative arthritis can be expected to produce pain, and both 

have been identified as possible causes of James' back pain. See 

Luna v. Bowen, 834 F.2d 161, 164 (10th Cir. 1987)(claimant must 

produce objective medical evidence showing an impairment "'which 

could reasonably be expected to produce the pain ... 

alleged'") (quoting 42 u.s.c. § 423(d) (5) (A)). 

The ALJ found that James' testimony regarding the severity of 

her pain was not credible. "[W)e generally treat credibility 

determinations made by an ALJ as binding upon review." Gossett v. 

Bowen, 862 F.2d 802, 807 (10th Cir. 1988). Our review of the 

record supports the ALJ's determination of credibility. Notes by 

various physicians indicate that James' complaints of pain appear 

to be intensified by her somatization and hypochondria. While 

these reports might, in some instances, support a finding of 

disability, none contains any indication that James' pain is of 

5 

Appellate Case: 91-7075 Document: 010110246218 Date Filed: 04/30/1992 Page: 5
such severity as to be disabling. In fact, the record contains no 

indication by any physician that James is disabled for any reason. 

While James does experience pain, an inability to work 

pain-free is not a sufficient reason to hold that she is disabled. 

Id. No evidence in the record supports a finding that James could 

not return to her past relevant work. 

James argues that the ALJ did not fulfill his duty of 

inquiry. James appears to argue that the ALJ was required to 

further examine her in order to obtain sufficient evidence to find 

her disabled. The ALJ gave James every opportunity to offer 

further statements regarding her condition. Further, the burden 

of proof remained on James to prove that she was disabled. See 

Williams, 844 F.2d at 751 n.2. James offered no objective 

evidence supporting her position that she could not return to her 

previous work. Indeed, no physician opined that James was 

disabled in any manner. Because the ALJ determined that James was 

not entirely credible, additional subjective testimony would not 

have helped her meet her burden. The ALJ proceeded properly. 

The judgment of the United States District Court for the 

Eastern District of Oklahoma is AFFIRMED. 

Entered for the Court 

John L. Kane, Jr. 

Senior District Judge 

6 

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