Opinion ID: 194609
Heading Depth: 2
Heading Rank: 1

Heading: Back Condition

Text: The record contains conflicting evidence concerning the effect of claimant's back problem on his physical capabilities. X-ray results showed a 20 to 25 percent narrowing of the disc space at L5-S1, suggestive of a bulging or herniated disc. Also, a C-T scan revealed a possible bulging or herniated disc at L4-L5 with a slight swelling of the left nerve root. Over the course of his treatment at the State Insurance Fund, claimant's condition varied. For example, on September 30 and October 13, 1988, claimant exhibited persistent lumbar muscle spasm and limited range of motion. However, a November 2, 1988 special medical report stated that claimant's back was well and there was no muscle spasm. In addition, claimant's range of motion was normal and there were no neurological deficits. The report concluded that claimant could perform light work and should be referred to vocational rehabilitation. Although claimant exhibited marked limitation in the movement of his trunk on November 7, 1988, there still was no significant muscle spasm and claimant could walk without difficulty. When claimant was discharged from the SIF in April 1989, he had residuals -5- consisting of slight spasm of the para-vertebral muscles with slight limitation of movement of the trunk in all directions. Claimant refused a referral to vocational rehabilitation. A neurological evaluation performed in July 1989 revealed no evidence of paravertebral muscle spasms or motor atrophy; there was normal strength in all muscles and no motor reflex or sensory disturbances. Claimant's gait and posture were normal. He refused to bend his spine. In January 1990, claimant was again examined by a consulting neurologist. At this time, claimant could not walk on his heels or toes, exhibited some weakness of the left toe and had spasm in his paravertebral muscles. His range of motion was limited.1 A nonexamining physician completed an RFC form in August 1989. This form reveals that claimant can frequently lift and carry up to ten pounds and occasionally can lift and carry twenty pounds. He can only occasionally stoop and crawl. His disc pathology limits his ability to use his lower extremities to push and pull. However, he can sit, stand and walk for up to six hours per work day. The medical findings outlined above amply support the conclusion that claimant retained the ability to meet the 1. Neither of these physicians filled out RFC assessments despite the requirement in the regulations that a complete consultative examination should include such findings. See 20 C.F.R. 404.1519n(c)(6). -6- exertional demands of sedentary work. Muscle spasm and limits in range of motion were not consistently present. Further, claimant rarely exhibited any neurological or motor deficits. Finally, the RFC assessment indicates that claimant's disc problems would not prevent him from working at the sedentary level. Because a reasonable mind, reviewing the evidence in the record as a whole, could accept it as adequate to support his conclusion, we must uphold the Secretary's factual determinations. Rodriguez v. Secretary of Health and Human Services, 647 F.2d 218, 222 (1st Cir. 1981).