Marc A. Ukolov v. Jo Anne B. Barnhart, Commissioner of Social Security
Docket: 03-35589
Court: Court of Appeals for the Ninth Circuit; August 23, 2005; Federal Appellate Court
Marc A. Ukolov appealed the district court's affirmation of the Commissioner of Social Security Administration's denial of his applications for disability insurance benefits and supplemental security income. Ukolov claimed he was unable to work due to conditions including multiple sclerosis, fibromyalgia, and other impairments. The Administrative Law Judge (ALJ) followed the five-step sequential evaluation process and determined that Ukolov did not have a "severe impairment" that significantly limited his ability to perform basic work activities. The ALJ evaluated Ukolov's asserted impairments, including physical and mental health issues, and considered the opinions of medical professionals, particularly Dr. Gajanan Nilaver, who noted the absence of a definitive neurological diagnosis despite extensive examinations. The Appeals Council upheld the ALJ's decision, leading Ukolov to seek relief in the district court, which also affirmed the denial of benefits. Ukolov argued that the ALJ erred by not recognizing his fall tendency as a basis for disability. The Ninth Circuit reviewed the case de novo, highlighting that the claimant bears the burden of proving disability, and upheld the denial as it was supported by substantial evidence without legal error.
In disability cases, while a treating physician's opinion is generally given significant weight, it is not determinative for an Administrative Law Judge (ALJ) regarding the existence of an impairment or the final decision on disability status. Ukolov contends that the ALJ incorrectly overlooked Dr. Nilaver's observations about his gait and balance issues. However, Dr. Nilaver's comments were insufficient to demonstrate a medically determinable impairment necessary for Social Security benefits. Under the Social Security Act, disability is defined as the inability to engage in substantial gainful activity due to a medically determinable physical or mental impairment lasting at least 12 months. Such impairments must be demonstrable through clinical and laboratory diagnostic techniques, not solely based on symptoms. The Social Security Administration's Ruling SSR 96-4p emphasizes that medical evidence, including signs and laboratory findings, is essential to establish an impairment. Symptoms alone, regardless of their genuineness, cannot confirm the existence of an impairment. Dr. Nilaver's letter failed to meet these criteria, lacking any objective medical evidence or a definitive opinion on impairment. Consequently, Ukolov's claim does not satisfy the necessary standards for establishing a disability.
Dr. Nilaver documented Ukolov's subjective complaints, such as gait ataxia, balance issues, dizziness, and an increased tendency to fall. However, these complaints were based solely on Ukolov's self-reported perceptions and did not substantiate an impairment under the relevant regulations (20 C.F.R. 404.1528(a), (b), 416.928(a), (b)). Dr. Nilaver also noted objective findings, including a wide-based stance, difficulty with tandem walking, and mild high steppage on the right side, but acknowledged the lack of a precise etiologic diagnosis and insufficient evidence to diagnose multiple sclerosis.
Dr. Kimberly Goslin corroborated some of these findings, noting weakness in the distal lower extremities and a positive Romberg test. Despite being labeled as objective, these observations lacked a formal diagnosis or impairment finding. The positive Romberg test, while initially suggestive of impairment, is subject to manipulation by the individual tested; Ukolov's unsteadiness was noted to increase when he was aware of being observed, and other Romberg tests yielded negative results.
The text emphasizes that a single positive Romberg test, without accompanying diagnosis or impairment finding, cannot establish disability, contrasting it with more definitive diagnostic tests such as blood pressure screenings or MRIs. According to SSR 96-6p, medical opinions must include symptoms and a diagnosis to support impairment claims. As none of the medical opinions indicated an impairment, diagnosis, or objective test results, Ukolov did not meet the burden of proof for disability. Therefore, the ALJ's finding of no impairment at step two of the disability evaluation process was legally sound, as a condition must present as severe to qualify as disabling.
The ruling was affirmed by Senior United States District Judge William W. Schwarzer. Dr. Nilaver suggested that Ukolov exhibited symptoms indicative of a demyelinating disease, like multiple sclerosis; however, Ukolov was not diagnosed with multiple sclerosis, and neurological tests eliminated demyelinating disease as a possibility. While Social Security Rulings (SSRs) do not hold legal power, they reflect the Commissioner's interpretation of regulations and warrant some deference if they align with the Social Security Act. SSR 96-4p aligns with the objectives of Title II and XVI of the Social Security Act, aimed at providing financial support to disabled individuals. Ataxia is defined as the inability to coordinate muscle activity during voluntary movements. The Romberg test, which assesses balance by having a person stand with feet together and eyes open and then closed, can indicate unsteadiness if the eyes being closed worsens the condition. The lay witnesses' testimonies focused solely on symptoms; thus, any oversight by the Administrative Law Judge (ALJ) regarding this testimony did not influence the case's outcome.
