STANLEY A. BOONE, Magistrate Judge.
Plaintiff Alicia Hernandez De Munoz ("Plaintiff") seeks judicial review of a final decision of the Commissioner of Social Security ("Commissioner" or "Defendant") denying her application for disability benefits pursuant to the Social Security Act. The matter is currently before the Court on the parties' briefs, which were submitted, without oral argument, to Magistrate Judge Stanley A. Boone.
Plaintiff suffers from carpal tunnel syndrome. For the reasons set forth below, Plaintiff's Social Security appeal shall be denied.
Plaintiff protectively filed an application for a period of disability and disability insurance benefits and a Title XVI application for supplemental security income on May 30, 2014. (AR 72, 73.) Plaintiff's applications were initially denied on December 12, 2014, and denied upon reconsideration on March 25, 2015. (AR 96-99, 102-106.) Plaintiff requested and received a hearing before Administrative Law Judge Mary P. Parnow ("the ALJ"). Plaintiff appeared for a video hearing on December 15, 2016. (AR 41-.) On February 22, 2017, the ALJ found that Plaintiff was not disabled. (AR 21-35.) The Appeals Council denied Plaintiff's request for review on February 13, 2018. (AR 2-4.)
Plaintiff appeared for the video hearing with her attorney and testified with the assistance of a Spanish language interpreter. (AR 42-53.) Plaintiff was 55 years old on the date of the hearing. (AR 43.) Plaintiff attended school in Mexico and completed the third grade. (AR 44.) Plaintiff lives in a house with her husband and adult daughter. (AR 46-47.) Plaintiff has difficulty speaking English and cannot read or write in English. (AR 47.) She is right handed. (AR 47.)
Plaintiff worked packing vegetables at Bolthouse Farms. (AR 44.) Plaintiff stopped working at Bolthouse Farms because her hands were bad and she could not saw anymore. (AR 45.) She also worked seasonally in the fields packing grapes. (AR 45.) During the season, Plaintiff would work eight hours a day five days a week. (AR 45.) She was told that she could not do repetitive work but does not remember what she did after that. (AR 46.) When she was packing grapes, she was able to take breaks while waiting for the grapes to get there and that enabled her to work. (AR 46.) She had surgery on her right hand and did not return to work after that. (AR 46.) She was given some training in cake decorating as part of her Workers' Compensation claim. (AR 47.) She completed the program but did not work as a cake decorator. (AR 48.)
Plaintiff is unable to work because her hands have gotten worse and her back and knees hurt, but the major problem is her back. (AR 48.) She wears a brace on her right wrist and wears it especially when she is driving so that her wrist does not hurt. (AR 48.) She does not use a brace for her right wrist. (AR 48.) Plaintiff has a lot of problems with her left hand and has informed her doctor but he is just treating her back. (AR 48.)
Plaintiff is able to stand one and a half to two hours and can walk for one hour. (AR 49.) She would then need to rest for 15 minutes. (AR 49.) Plaintiff can lift a gallon of milk using two hands. (AR 49.) She needs to use two hands to lift a coffee cup or it will fall. (AR 49.) She has a weak grip and trouble holding onto things with both of her hands. (AR 49-50.) Her fingers regularly get numb. (AR 50.) Her back is hurting but they have not been able to figure out why. (AR 51.)
Plaintiff drives to the store, to meetings, and to appointments but it requires a lot of effort with her left hand and her back bothers her. (AR 50.) Plaintiff is unable to get clothes out of the dryer and cannot carry a load of clothes. (AR 50.) She can wash simple dishes but cannot hold or wash a heavy pot. (AR 50.) Plaintiff has trouble cooking and her husband helps her. (AR 51.) Her husband does the yardwork. (AR 51.)
Plaintiff is a Jehovah Witness and goes to weekly meetings on Wednesdays at 7:00 p.m. and Sundays at 1:00 p.m. (AR 51.) The meetings are 45 minutes to 1 hour long. (AR 51.) She has trouble sitting through the meetings and gets up to go to the bathroom. (AR 51.) Plaintiff goes door-to-door sometimes but other times they just give her the house numbers and she drives door-to-door. (AR 51.)
Plaintiff went on a trip to Mexico with her husband. (AR 51.) While her husband was in Mexico, he had an accident and ended up in the hospital. (AR 51-52.) She went to see him while he was there and came back in an airplane when he was able to travel. (AR 52.)
Plaintiff had a Workers' Compensation claim that settled for around $17,000.00. (AR 52-53.) She does not currently have an outstanding Workers' Compensation claim. (AR 52.)
Joel Greenberg, a vocational expert ("VE"), also testified at the hearing. (AR 53-56.)
The ALJ made the following findings of fact and conclusions of law.
(AR 29-34.)
To qualify for disability insurance benefits under the Social Security Act, the claimant must show that she is unable "to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." 42 U.S.C. § 423(d)(1)(A). The Social Security Regulations set out a five-step sequential evaluation process to be used in determining if a claimant is disabled. 20 C.F.R. § 404.1520;
Congress has provided that an individual may obtain judicial review of any final decision of the Commissioner of Social Security regarding entitlement to benefits. 42 U.S.C. § 405(g). In reviewing findings of fact in respect to the denial of benefits, this court "reviews the Commissioner's final decision for substantial evidence, and the Commissioner's decision will be disturbed only if it is not supported by substantial evidence or is based on legal error."
"[A] reviewing court must consider the entire record as a whole and may not affirm simply by isolating a specific quantum of supporting evidence."
Plaintiff argues that the ALJ erred by failing to provide specific and legitimate reasons to reject the opinion of Dr. Lewis that she needed find a job that does not require repetitive use of her hands on a consistent basis. Plaintiff contends that in Workers' Compensation terms, repetitive means that she has lost fifty percent of her pre-injury capacity and the ALJ did not provide any reasons for rejecting Dr. Lewis' opinion that Plaintiff was unable to repetitively use her hands on a consistent basis.
The Commissioner states that the ALJ considered Dr. Lewis' opinion and that the ALJ did not reject his opinion. The Commissioner argues that Dr. Lewis' notes are a medical finding that the ALJ translated into the residual functional capacity assessment. The Commissioner contends that Dr. Lewis' use of repetitive and consistent are not terms that reflect Social Security's consideration of the frequency of work-related tasks. The Social Security framework defines frequency using a scale of Not Present, Occasionally (up to one-third of the time), Frequently (from one-third to two-thirds of the time), and Constantly (two-thirds or more of the time). The Commissioner contends that the the ALJ translated Dr. Lewis' opinion into the concrete, functional restriction of frequent handling, fingering and feeling.
The weight to be given to medical opinions depends upon whether the opinion is proffered by a treating, examining, or non-examining professional.
On March 31, 2015, Dr. Marshall S. Lewis provided a primary treating physician's comprehensive orthopedic evaluation and request for authorization in Plaintiff's Workers compensation case. (AR 446-452.) Plaintiff was seen for a follow-up on her industrial injury of December 13, 2006. (AR 447.) Plaintiff reported that she still had a lot of pain. (AR 447.) Dr. Lewis considered an October 20, 2014 report from Dr. Pechman that found Plaintiff was a qualified injured worker. (AR 447.) Dr. Pechman recommended further therapy and medications for Plaintiff's right shoulder. (AR 447.) Dr. Pechman discussed that Plaintiff's right wrist was permanent and stationary and her left wrist had non-operative care. (AR 447.) EMG/nerve conduction studies on February 28, 2007 and January 29, 2008 indicated that Plaintiff had mild bilateral carpal tunnel syndrome. (AR 447.) A September 25, 2008 EMG/nerve conduction study was normal. (AR 447.) A June 30, 2009 EMG/nerve conduction study showed minimal bilateral carpal tunnel syndrome. (AR 447.) Dr. Pechman found that Plaintiff had a whole person impairment of fourteen percent. (AR 447.)
An October 20, 2014, report from Dr. Pechman stated that the current EMG/nerve conduction study substantiates left hand carpal tunnel syndrome and recommended that therapy be left open for medications, injections, and splinting with possible carpal tunnel release surgery. (AR 447.)
On examination, Dr. Lewis found that Plaintiff's scars were well healed. (AR 448.) Her range of motion was well-preserved, although she did have some findings of residual carpal tunnel symptomology bilaterally. (AR 448.) Plaintiff was diagnosed with "1. Degeneration of thoracic or thoracolumbar intervertebral disc. 2. Disorder of bone and cartilage. 3. Carpal tunnel syndrome. 4. Sprain/strain cervical spine. (AR 448.) Dr. Lewis recommended that Plaintiff should be using a warm-water type of treatment and that she get into a warm-water pools and do exercises which would be beneficial for her whole body, as well as her upper extremities. (AR 449.) As to work status, Dr. Lewis found that Plaintiff is a qualified injured worker and needed to find a job that did not require repetitive use of her hand on a consistent basis. (AR 449.)
Although the ALJ considered the findings of Dr. Lewis (AR 32), he did not assign any weight to the opinion or reject the findings. Therefore, the Court finds that the issue here is whether Dr. Lewis' opinion is consistent or inconsistent with the residual functional capacity finding.
Plaintiff argues that Dr. Lewis's finding that she cannot do work requiring repetitive use of her hands is inconsistent with the finding that she is able to do frequent handling, fingering, and feeling. However, Dr. Lewis did not restrict Plaintiff to no repetitive use of her hands. He found that Plaintiff could not consistently do repetitive movement with her hands. The terms used and the manner is which work is categorized is different under the Social Security regulations than it is under California's Workers Compensation scheme.
Plaintiff cites to
In
In a footnote the court stated,
In
Plaintiff reads the ALJ's findings in this instance to be inconsistent with that of Dr. Lewis, but she is conflating the meaning of repetitive and frequent. Under the agency's regulations "Frequent" means occurring from one-third to two-thirds of the time. SSR 83-10. While the agency does not define repetitive, as discussed above the meanings of frequent and repetitive in the context of social security are distinct.
The ALJ considered that Dr. Lewis opined that Plaintiff should avoid repetitive use of her hand on a consistent basis. The ALJ also considered that Dr. Lewis examined Plaintiff on February 17, 2015 and his examination showed well preserved range of motion in the bilateral wrists and adequate grip strength. (AR 32, 454.) On March 31, 2015, Plaintiff saw Dr. Lewis who found that her examination results had not changed. (AR 32, 448.) Although Plaintiff argues that Dr. Lewis's statement that she cannot do a job requiring repetitive use of the hands on a consistent basis is inconsistent with the ALJ's finding that she can frequently finger, handle and feel, the ALJ could reasonably interpret the finding to allow frequent fingering, handling and feeling. Dr. Lewis did not address the frequency with which Plaintiff was able to use her hands, but found that she should not consistently perform repetitive motion. The ALJ's interpretation that Dr. Lewis's limitation to no repetitive use of her hands on a consistent basis would allow her to use her hands frequently under the social security regulations is reasonable.
The Court finds that the ALJ did not improperly reject Dr. Lewis's findings.
Plaintiff argues that the VE testified that a limitation against repetitive use of the hands would preclude all work. The Court construes this argument to contend that the residual functional capacity ("RFC") assessment is not supported by substantial evidence in the record. The Court therefore considers whether there is substantial evidence in the record to support the ALJ's finding that Plaintiff is able to perform frequent handling, feeling, and fingering.
A claimant's RFC is "the most [the claimant] can still do despite [his] limitations." 20 C.F.R. § 416.945(a)(1). The RFC is "based on all the relevant evidence in [the] case record." 20 C.F.R. § 416.945(a)(1). "The ALJ must consider a claimant's physical and mental abilities, § 416.920(b) and (c), as well as the total limiting effects caused by medically determinable impairments and the claimant's subjective experiences of pain, § 416.920(e)."
The ALJ found that due to the repetitive nature of her job duties, Plaintiff had developed bilateral carpal tunnel syndrome. (AR 31. 3F, 4) She underwent right carpal tunnel release with a satisfactory result on April 7, 2014.
On May 6, 2014, Dr. Lewis examined Plaintiff and noted that Plaintiff had not gone to therapy, apparently through a miscommunication. (AR 309.) She had some tenderness with range of motion reasonably well preserved and poor grip strength. (AR 309.)
On June 10, 2014, Dr. Lewis noted,
(AR 300-301.)
On July 15, 2014, Dr. Lewis noted that Plaintiff flinched and grimaced during palpation to her hand. (AR 291.) Plaintiff's grip strength while "testing manually appears to be adequate and equal to the population norm however with 5-position Jamar grip strength testing done twice and findings to the right hand indicated "most likely magnification or malingering has to be entertained." (AR 291-292.)
On August 8, 2014, Plaintiff failed to keep an appointment for an agreed upon examination with Dr. Pechman. (AR 414.)
On August 26, 2014, Plaintiff saw Dr. Lewis who found that she had diminished grip on the right compared to the left side of 4+/5+ without any impingement of range of motion. (AR 282.) She had no visible hand atrophy and no weakness of the intrinsic muscles in the hand. (AR 282.)
Other than tenderness to palpation, Plaintiff had a normal examination by Dr. Pechman on October 20, 2014, and grip strength testing indicated suboptimal effort. (AR 31, 364-368.) Dr. Pechman found
(AR 406.)
On November 24, 2014, Dr. Lewis noted that Plaintiff has a weak grip with pain to the same. (AR 274.)
Plaintiff saw Dr. Lewis on January 5, 2015, and he found that her grip strength remained poor. (AR 264.)
Plaintiff had neurological testing on February 3, 2015, including an EMG and nerve conduction study. (AR 31, 331-333.) She was found to have mild left carpal tunnel syndrome and median sensory latencies through the right carpal tunnel that were borderline normal. (AR 32, 333.)
On February 17, 2015, Plaintiff was examined by Dr. Lewis and found to have well preserved range of motion and adequate grip strength. (AR 32, 454.) On this same date, Dr. Pechman stated that he had reviewed February 3, 2015 report and there was no reason to change his prior findings. (AR 32, 342-351.)
Plaintiff saw Dr. Lewis again on March 31, 2015 and examination findings remained the same. (AR 32, 448.)
The ALJ noted that Plaintiff did complain of left-hand pain on March 11, 2016. (AR 32, 518.) She was found to have mild pain with motion. (AR 521.) The ALJ also reviewed treatment notes from March 12, 2014 through November 21, 2016, which revealed no complaints of carpal tunnel related symptoms. (AR 32-33, 492-581.)
The ALJ considered the opinion of Dr. Wagner who conducted an internal medicine consultative examination of Plaintiff on November 20, 2014. (AR 33, 249-253.) Dr. Wagner noted that Plaintiff used a splint on her right wrist which appeared to be helpful after surgery. (AR 251.) Plaintiff was found to have positive Tinel's on the left, but not on the right wrist. (AR 33, 252.) Plaintiff had good dexterity and was able to easily oppose fingertips to thumb tips and pick up a paperclip with each hand. (AR 33, 252.) Her grip strength was 4+/5 in the right hand and 5-/5 in the left hand. (AR 252.) Dr. Wagner noted that Plaintiff complained of some pain and numbness in the ulnar distribution primarily and some pain and numbness in the left ulnar distribution and Plaintiff was diagnosed with carpal tunnel. (AR 33, 252.) Dr. Wagner opined that Plaintiff could frequently perform manipulative activities. (AR 33, 253.)
Here, Dr. Wagner examined Plaintiff and made independent findings in assessing Plaintiff's functional capacity. He found that Plaintiff had some diminished grip strength and complained of pain, but he opined that she was able to frequently perform manipulative activities. The ALJ gave significant weight to this opinion finding that it was consistent with the record as whole, supported by the relevant evidence, and because Dr. Wagner had program knowledge. (AR 33.) Dr. Wagner's opinion is substantial evidence in support of the ALJ's findings that Plaintiff is able to frequently finger, handle, and feel.
The VE was asked if an individual who was limited to only frequently handling, fingering and feeling would be able to perform Plaintiff's past jobs and the ALJ stated that she would. (AR 54-55.) As the hypothetical provided to the VE included the limitations in Plaintiff's RFC, the Court finds no error in the finding that Plaintiff is able to perform her past relevant work.
Based on the foregoing, the Court finds that the ALJ did not err in considering the opinion of Dr. Lewis or by finding that Plaintiff was capable of her past relevant work.
Accordingly, IT IS HEREBY ORDERED that Plaintiff's appeal from the decision of the Commissioner of Social Security is DENIED. It is FURTHER ORDERED that judgment be entered in favor of Defendant Commissioner of Social Security and against Plaintiff Alicia Hernandez De Munoz. The Clerk of the Court is directed to CLOSE this action.
IT IS SO ORDERED.