Opinion ID: 780054
Heading Depth: 2
Heading Rank: 2

Heading: The Decisions of the DHO and the ALJ

Text: 15 Veino sought reconsideration. The disability hearing officer (DHO), in a decision dated April 28, 1998, concluded that Veino was not disabled (DHO Decision). The DHO stated that the issues to be determined were whether Veino was disabled and whether DAA [ i.e., drug or alcohol addiction] is a contributing factor material to the finding of disability. (DHO Decision at 1.) The DHO made the following findings: 16 The hearing officer has reviewed the medical, vocational and other information in the claimant's claims folder pertaining to the issue(s) described above. The hearing officer has also reviewed the testimony and any additional documentary evidence submitted at the disability hearing. After careful consideration of all evidence, the hearing officer makes the following findings: 17 Claimant was found eligible for continued benefits effective 05/15/73 in the comparison point decision[](CPD) of 10/05/92 [ sic ] due to an anxiety disorder, paranoid personality and alcoholism of a severity to meet Listing 12.04A7bB. His benefits were ceased effective 11/97. It was determined that his condition had improved since the comparison point decision[] (CPD) of 10/05/82 and that he could perform simple low stress work. 18 At the CPD, evidence shows the claimant was very tense and suspicious. He was agitated with an enormous amount of intense rage and anger just below the surface. His expressed attitude was paranoid in nature, feeling he was being ripped off by the world. He was not psychotic and had no delusions or hallucinations. He complained of combat fatigue from his tour in Vietnam.[] He said he shook a lot in that he trembled constantly. He was observed to have hand tremors at rest on clinical psychological exam. He was oriented to time, place and person. Memory and concentration were intact. He was able to repeat five digits forward and three in reverse. He gave up on serial 7's. He was depressed with insomnia, suicidal and homicidal ideation but no plan. He had migraine headaches occasionally, with some lasting 18 days and not helped by pain medication. He was a loner, would not go into a public place by himself and had little contact with the community. He did have a few friends and one would come to his home to visit. He did no shopping and his wife managed their money. He rarely did household chores. His days were spent mainly watching TV. He did leave the home for his doctor appointments and to cash his check. He had a history of abusing alcohol. On 9/17/92 he denied abuse of alcohol to his treating psychiatrist and admitted use of eight cans of beer a day to a consulting psychologist he saw once.... 19 Currently, claimant continues to complain of combat fatigue with the shakes, not associating with people and feeling uncomfortable leaving the home. He says his condition has essentially not changed in the past 20 years. He has not been in therapy or been on medication for five to six years. There are no symptoms or signs of anxiety on psychological exams. No shaking or tremors are observed. Claimant does report symptoms of agitation and insomnia at night. He will wake up in a cold sweat because of nightmares and will pace the floor. He has suicidal thoughts recently but no plan. He has never attempted suicide. There continues to be no thought disorder, delusions or hallucinations. He is alert and oriented to time, place and person. Concentration and memory are intact. He is able to repeat six digits forward and four in reverse. He was unable to do serial 7's on minimal effort. Claimant is alcohol and marijuana dependent. He smokes an ounce of marijuana a month and drinks up to a 12 pack of beer a day. 20 .... He seldom leaves the house except for appointments. Once in a while friends will come visit him. He does not drive. He has lost his license due to DWI's.... 21 An analysis of the total evidence establishes that when the claimant is not abusing alcohol and drugs, he would be capable of understanding, remembering and carrying out simple job tasks where contact with others would be minimal in a routine work situation on a sustained basis. He would be able to meet all the basic mental demands necessary to do low stress unskilled work. When abusing drugs and alcohol he is unable to attend work and perform the tasks necessary for simple unskilled work on a sustained basis. Thus he would not be able to meet all the basic mental demands for even unskilled work.... 22 (DHO Decision at 3-4.) 23 The DHO concluded that there [had] been medical improvement of [Veino's] impairment(s) since the comparison point decision, stating that 24 [a]t the comparison point decision[] (CPD) claimant had severe anxiety such that he trembled constantly and had visible hand tremors. He was very tense, suspicious, and agitated. He was fully oriented. He could remember five digits forward and three in reverse. He was a loner but did have some friends who visited him. He rarely did any household chores. He drank eight cans of beer a day. Currently, claimant reports the shakes and is agitated at night. He exhibits no symptoms or signs of anxiety on exam. There is no shaking or tremors. He is still fully oriented. He can remember six digits forward and four in reverse. He continues to be a loner and friends still visit him occasionally. He does most of the household chores. He drinks up to a twelve pack of beer a day. Since the symptoms, signs and lab findings show a decrease in the medical severity of the impairment, it is concluded that the claimant's impairment has improved since the CPD. 25 ( Id. at 6.) Finding that [a]t the time of the comparison point decision[](CPD), [Veino's] impairment met Listing 12.04, see 20 C.F.R. Pt. 404, Subpt. P, App. 1, and that his impairment no longer meets that Listing, the DHO concluded that [Veino's] medical improvement is related to the ability to work. (DHO Decision at 7.) 26 The DHO also found that Veino's alcohol and drug condition results in restrictions in concentration, persistence and pace, and that [s]ince these are work related activities, it is concluded that the claimant has a severe impairment. ( Id. ) The DHO concluded that 27 the jobs [Veino] could do are severely reduced by his drug and alcohol abuse. He is unable to attend and concentrate and complete a normal work day or workweek on a sustained basis. Thus he would not be able to meet all the basic mental demands necessary to do even unskilled work. 28 .... 29 Claimant's substance abuse is a contributing factor material to the determination of disability. In the absence of substance abuse, he would be capable of performing a wide variety of unskilled work at all exertional levels. 30 .... 31 The claimant is found to be: NOT DISABLED[.] 32 ( Id. at 10-11.) 33 Veino sought review of the DHO's Decision; accordingly, a hearing was held before an administrative law judge (ALJ) in December 1998. Veino, represented by counsel, testified and called his wife as a witness. The ALJ marked as exhibits various documents, including reports from an SSA consultative psychologist and two SSA nonexamining reviewers, and called a vocational expert to testify as to the existence of jobs in the regional and national economy that a person with Veino's characteristics could perform. The ALJ also stated, [w]e also have the records upon which the determination of disability was made at a prior time (Hearing Transcript, December 3, 1998 (Tr.), at 2), but the transcript does not indicate that those prior records were marked as exhibits. 34 Following the hearing, Veino submitted evidence from his physician, Dr. John Frederick King, M.D. According to Dr. King, who had been Veino's treating psychiatrist since approximately November 1997, Veino suffered from post traumatic stress disorder, anxiety disorder, and repeated intrusive recollections of past traumatic experiences; in addition, Veino probably had a paranoid personality and experienced panic. In response to interrogatories, Dr. King opined, inter alia, that Veino's mental condition would interfere with his ability to carry on normal daily activities[,] ... his ability to interact appropriately with other individuals (such as family members, friends, neighbors) or to interact and cooperate with others (such as supervisors at work, co-workers, and members of the public)[, and] ... his ability to concentrate or maintain a persistent pace in completing tasks either at work or in his personal life. (Answers to Interrogatories 6-8.) Dr. King concluded that Veino's mental disorders and their symptoms as described above exist independent of any use of alcohol or illegal drugs (Answer to Interrogatory 10), and that if Veino were to entirely stop using alcohol or illegal drugs, it was likely that his mental disorders would persist substantially as described above (Answer to Interrogatory 11). 35 In a decision dated May 28, 1999, the ALJ determined that Veino's medical condition had so improved that he was no longer disabled (ALJ Decision). 36 Medical improvement is defined as any decrease in the medical severity of the impairment which was present at the time of the most recent favorable medical decision that the individual was disabled or continued to be disabled. The medical improvement must be related to an ability to work. 37 .... 38 At the time of the comparison decision dated October 5, 1982 the claimant trembled and had migraines. He did not like being around people and had intense anger. He heard voices and was homicidal. He was oriented and his memory was intact. He was withdrawn, tense and suspicious. 39 (ALJ Decision at 2, 3.) The ALJ found, however, that those conditions had changed: 40 The evidence reveals that the claimant did not require treatment or medication for six years. During a consultative examination his attention and concentration were adequate. He did not demonstrate any unusual motor behavior and had no tremors or shaking. There were no symptoms of post traumatic stress disorder, no symptoms of apprehension or anxiety.... The medical evidence shows clear improvement in the claimant's condition. In examinations conducted by Dr. King the claimant was focused on retaining his Social Security benefits. Dr. King described the claimant as stable on Effexor and Inderol. He is able to function on a daily basis. His condition clearly improved. 41 ( Id. at 5.) 42 The ALJ discounted the other opinions proffered by Dr. King, noting that he had been Veino's treating physician only since November 1997, that his opinions appeared to be based only on statements by Veino rather than on any clinical evidence or any detailed longitudinal picture of [Veino's] mental condition ( id. at 4), and that Dr. King's views were in conflict with those of the SSA's consultative expert. The ALJ found that the statements of Veino himself were not entirely credible because he was focused on the loss of his disability benefits. ( Id. at 5.) 43 The ALJ found that Veino continue[d] to have some restrictions and he would be limited from working a jobs [ sic ] involving too much interpersonal contact with the general public, co-workers and supervisors. ( Id.; see also id. at 7 (Mr. Veino would be limited to only minimal contact with the general public, co-workers and supervisors.)) The ALJ credited, however, the testimony of the vocational expert, who had assum[ed] Mr. Veino's specific work restrictions ( id. ) and had opined that Veino could perform the job of surveillance systems monitor, of which there were 60 in Vermont and New Hampshire, and 8,000 nationally; the job of companion, of which there were 576 in Vermont and New Hampshire, and 80,000 nationally; and the job of night watchman, of which there were 1,620 in Vermont and New Hampshire, and 800,000 nationally. 44 The ALJ concluded that Veino's medical condition had improved and that Veino could perform the above jobs, although her findings as to the date on which Veino's disability ceased seem inconsistent. The ALJ's findings include the following: 45 9. The claimant's ability to perform a full range of medium work is reduced by his inability to have more than limited interactions with the general public, co-workers and supervisors.... 46 .... 47 14. Beginning November 30, 1997 the claimant had the residual functional capacity to perform a full range of medium work, which was reduced by his inability to have more than limited interactions with the general public, co-workers and supervisors.... 48 15. For the period November 30, 1997 to May, 1998 the claimant abused alcohol and marijuana. While drinking he had decreased concentration, persistence and pace, which would have compromised any job base. Therefore, alcohol was a factor material to disability. Absent the alcohol and marijuana abuse his limitations would be consistent with those outlined above, as such the medical evidence establishes that the claimant would not be disabled if he stopped using alcohol and drugs. Therefore in accordance with Section 105 of Pub.L. 104-121, enacted on March 29, 1996, the claimant was ineligible for disability benefits under Title II of the Act. 49 16. Beginning May, 1998 the claimant's alcohol and drug addiction was in remission and he was able to perform a range of work as outlined above.... [T]here are a significant number of jobs in the national economy which the claimant could perform. Therefore, the claimant is no longer disabled. 50 17. Alcohol abuse was a contributing factor material to the claimant's disability from November 30, 1997 to May 1, 1998 and he was therefore ineligible for disability benefits. 51 17. [ sic ] Beginning May 1, 1998 [sic] the claimant[]'s disability ceased.