Opinion ID: 28990
Heading Depth: 2
Heading Rank: 1

Heading: examiner found him moderately to severely

Text: Masterson, an accountant by training, ap- impaired in his occupational functioning, and plied for Social Security disability benefits in that he had service-connected disabilities for 1994, claiming he had suffered from post- shell fragment wounds to the left chest and left traumatic stress disorder (“PTSD”) since arm.1 VA medical records also indicate that 1993 because of his combat service in Viet- Masterson had sleep apnea, which was well nam. Masterson contended that PTSD con- controlled with medication and a breathing tributed to an inability to work with others, apparatus. fear of the future, and intrusive thoughts. De- spite these alleged symptoms, he acknowl- In January 1995, Dr. George Robison peredged that he still could perform everyday formed a consultative medical examination at tasks and tend to his personal needs. the request of the Texas Rehabilitation Commission. Masterson reported that he had back After Masterson’s application was denied pain, but no radiation, and that he did not find initially and on reconsideration, he requested a the pain limiting. Robison reported Masde novo hearing before an ALJ, who con- terson’s past medical history of PTSD and sidered Masterson’s medical history and po- noted that Masterson’s hearing, emotional aftential evidence of PTSD. Medical records fect, and gross mental status were normal. from the Veteran’s Administration (“VA”) in- dicate that Masterson had complained of de- Also in January 1995, Dr. Stuart Nemir, Jr., pression and PTSD in 1991. The treating phy- performed a consultative psychological examsician, however, ruled out PTSD and diag- ination requested by the Texas Rehabilitation nosed dysthymia. Masterson then began psychotherapy. In December 1991, a VA phy- sician reported that Masterson had some 1 Masterson was hospitalized briefly in 1994 for PTSD symptoms and prescribed anti-de- chest pain caused primarily by his history of pressant medication. pleurisy or costochondritis. The discharge diagnosis was costochondritis with atypical chest pain and mild chronic obstructive pulmonary disease. 2 Commission. Masterson reported to Nemir expert, and a vocational expert. Masterson that he was active in Alcoholics Anonymous, testified that he was forty-seven years old with that he had a good relationship with his four a masters degree in accounting. He said he sons, and that his daily activities included pre- had difficulty sleeping, headaches, high freparing meals for himself and his son, driving quency hearing loss, skin problems, sleep aphis son to school, doing household chores, vis- nea, polyps on his colon, and depression. He iting with acquaintances on the phone, work- identified an inability to concentrate as the ing with the computer, engaging in leisure ac- main reason he could not work. He stated that tivities, and keeping up with current events he occasionally experienced chest pain, which through television and the newspaper. Nemir medication resolved within one minute. observed that Masterson was alert and his affect was appropriate; he saw no signs of Masterson also testified that at his last job, depression or thought disorder. he had threatened to assault two persons who had said something about the men who died in Nemir diagnosed personality disorder, not Vietnam being losers. He stated that he had otherwise specified, and sleep disorder. Nemir begun to hurt people years ago but had been concluded that if Masterson “has PTSD, it able to stop and that he had not assaulted anycertainly is atypical” and that “[w]ith this one since 1982. He said, however, that he reman’s educational background and talent to- cently had hit his twenty-one-year-old son in gether with his intelligence, I think the prog- the side of his head but did not injure him. nosis for him is fair to good.” Masterson stated that he did laundry once In June 1995, Robert O’Brien, Ph.D., a month, went grocery shopping late, watched another VA psychotherapist, reported that television, occasionally watched movies with Masterson continued to experience recurrent his son, read, played solitaire on the computer, combat memories and nightmares and demon- and attended Alcoholic Anonymous meetings, strated markedly diminished interest and par- after which he often would join others for a ticipation in significant activities. O’Brien meal. He attended therapy and lunched weekopined that Masterson had moderate problems ly with four friends, who were also combat in performing act ivities of daily living, mod- veterans. erate difficulty in maintaining social func- tioning, and frequent problems with concen- Dr. Joe Berry, a psychiatrist with forty-two tration, persistence, and pace that resulted in a years of experience, testified as a medical exfailure to complete tasks in a timely manner. pert and noted that the medical records O’Brien also indicated that Masterson often showed diagnoses of PTSD, alcohol depenfailed to start even simple tasks, such as re- dency, dysthymia, and a personality disorder. turning phone calls. He assessed chronic Berry stated that Masterson’s testimony did PTSD secondary to combat service and not sustain a diagnosis of PTSD. He also teswounding in Vietnam, dysthymia secondary to tified that, based on the medical evidence, PTSD, guilt, and sense of failure. Masterson had slight restrictions on daily activities, slight to moderate difficulties in so- The ALJ also heard testimony at the hear- cial functioning, and seldom to often-expering in June 1996 from Masterson, a medical ienced deficiencies of concentration. On 3 cross-examination, Berry testified that, based Social Security Act; (4) that Masterson’s on Masterson’s testimony, Masterson would allegations of disabling symptoms were not have moderate to marked restrictions of daily fully credible; (5) that the medical evidence did activities and moderate to marked difficulties not support the VA’s PTSD diagnosis; (6) that in maintaining social functioning, and he often Masterson had the residual functional capacity would experience deficiencies in concen- to perform sedentary and light work not tration. involving exposure to stressful situations or dealing with the public; (7) that Masterson had Dr. Robert Marion, Professor of Special skills transferrable to sedentary and light work; Education and Rehabilitation at the University and (8) that Masterson was able to perform of Texas at Austin, testified as a vocational ex- work existing in significant numbers in the pert and opined that Masterson had skills national economy. transferrable to sedentary and light jobs, given his education and age. Marion also said that The Appeals Council denied Masterson’s sedentary and light jobs not requiring much request to review the ALJ’s decision on the interaction with the public existed in significant merits. The Council reviewed the evidence numbers in the national economy. presented to the ALJ, as well as new evidence submitted by Masterson, namely, a report by Marion identified several sedentary jobs Dr. Kevin McFarley dated September 22, that Masterson could perform without expos- 1997. ure to stressful situations and with less public interaction than his previous accounting jobs McFarley reported that Masterson was currequired: assembly worker, order clerk, ap- rently functioning at the “Very Superior (Menpointment clerk, and security officer. Marion tally Gifted)” range of overall intellectual abilalso identified several suitable non-stressful ity. Although Masterson did not indicate any light jobs: mail clerk, general office clerk- significant area of cognitive or intellectual degopher, and assembly worker. Marion testi- ficit, McFarley stated that Masterson could not fied, however, that Masterson could not per- engage in productive work because of his ruform any of these jobs if he lost his concen- minations, psychological problems, and severe tration fifty percent of the time, as Masterson interpersonal problems. McFarley diagnosed had testified he did. PTSD and recurrent, moderate major depressive disorder. McFarley also stated that The ALJ denied Masterson’s application for Masterson was not malingering and that he benefits and made eight main determinations: was “currently completely disabled by the (1) that Masterson had not had substantial psychological and emotional effects of his gainful activity since March 31, 1993; (2) that combat experience.” Masterson suffered from obstructive sleep apnea and personality disorder but did not The Appeals Council concluded that Mchave an impairment or combination of Farley’s report did not justify a review of the impairments that met or equaled the severity of ALJ’s decision on the merits, much less a rean impairment listed in 20 C.F.R. Part 404, versal of the ALJ’s decision. The ALJ’s deSubpart B, Appendix 1.; (3) that Masterson cision thus became the Commissioner’s final was not disabled within the meaning of the and official decision when the Appeals Council 4 denied Masterson’s request for review on the 235 (5th Cir. 1994). merits. Masterson sought judicial review of the ALJ’s decision in the district court on B. February 15, 2000. We review the denial of benefits only to ascertain whether substantial evidence supports