ANDREW J. WISTRICH, Magistrate Judge.
Plaintiff filed this action seeking reversal of the decision of defendant, the Commissioner of the Social Security Administration (the "Commissioner"), denying plaintiff's application for supplemental security income ("SSI") benefits. The parties have filed a Joint Stipulation ("JS") setting forth their contentions with respect to each disputed issue.
The procedural facts summarized in the joint stipulation are undisputed. [
The Commissioner's denial of benefits should be disturbed only if it is not supported by substantial evidence or is based on legal error.
Plaintiff contends that the ALJ erred in finding that her fibromyalgia was not a severe impairment. [JS 4-7, 9-10].
A medically determinable impairment or combination of impairments is not severe if the evidence establishes "a slight abnormality that has no more than a minimal effect on an individual's ability to work."
The ALJ found that there was objective evidence in the record showing that plaintiff had been evaluated and treated for fibromyalgia, hypertension, menometrorrhagia, and Epstein-Barr virus, which was equated by a treating source to chronic fatigue syndrome. [AR 24]. The ALJ found that those conditions were being managed medically, and that no aggressive treatment was recommended or anticipated for them. [AR 24]. Accordingly, although the ALJ found they were medically determinable medical impairments, he found they were nonsevere because they were only slight abnormalities and did not have more than a minimal effect on plaintiff's ability to do basic physical and mental work activities. [AR 24].
Plaintiff poses no specific challenge to the ALJ's finding, except to say that the treatment she received revolved around her chronic pain and chronic fatigue. She suggests that because she was diagnosed with fibromylagia, and because that impairment shares a number of common features with chronic fatigue syndrome, the ALJ erred in not finding her fibromyalgia severe. [JS 6].
However, the mere fact that plaintiff received a diagnosis of fibromyalgia does not mean that it is either severe or disabling.
Moreover, the ALJ concluded that plaintiff's diagnosis of fibromyalgia was "questionable." [AR 30]. The ALJ explained that fibromyalgia is medically determinable if there are signs, primarily tender points, that are clinically established by the medical record. [AR 30]. The ALJ explained that the American College of Rheumatology ("ACR") defines the disorder as "widespread pain in all four quadrants of the body for a minimum duration of 3 months and at least 11 of the 18 specified tender points that cluster around the neck and shoulder, chest, hip, knee, and elbow regions." [AR 30]. The ALJ noted that other symptoms, may be signs of fibromyalgia if they have been clinically documented over time, such as irritable bowel syndrome, chronic headaches, temporomandibular joint dysfunction, sleep disorder, severe fatigue, and cognitive dysfunction. [AR 30].
The ALJ noted that an August 27, 2010 treatment note from LaSalle Medical Associates ("LaSalle") indicated plaintiff was "positive for 18 trigger points," reflecting a "possible" fibromyalgia diagnosis. [AR 30, 267, 305]. Although the ALJ gave plaintiff "the benefit of the doubt in finding that fibromyalgia is a medically determinable impairment," the ALJ also remarked that the record lacked sufficient positive clinical or diagnostic findings to satisfy the ACR criteria for fibromyalgia. [AR 30]. For example, periodic physical examinations revealed no positive findings of pain in areas other than the claimant's back. [AR 30, 309-310, 313-314, 320-321, 323-324;
In her reply, plaintiff challenges the ALJ's findings that no aggressive treatment was recommended or anticipated for her fibromyalgia, and that the condition would be amenable to control. [JS 9-10]. However, plaintiff points to nothing in the record contravening the ALJ's findings. A medically-determinable impairment that is controlled with medication or treatment may properly be considered non-severe.
Plaintiff contends that the ALJ improperly assessed her subjective symptom testimony. [JS 10-14, 16-17].
Plaintiff was represented by counsel during the administrative hearing in April 2012 and testified on her own behalf. [AR 43-61]. She is single and lives with her 16-year-old son, her mother, and her brother. [AR 44, 47-48.] Her son has chronic asthma, and he received social security benefits based on that condition. [AR 47]. Her brother was born disabled. [AR 48]. Her mother, who receives unemployment benefits, takes care of plaintiff's brother. [AR 48].
Plaintiff completed about a year of college including enough units to become a pre-school teacher. [AR 44]. She worked as a clerical worker at a center for children with disabilities in 1999 and 2000. [AR 45]. She was employed a few nights a week filing, answering phones, closing the center, and performing other clerical work. [AR 45]. She worked as a pre-school teacher in 2000 and 2001 "[o]ff and on for a few years at different pre-schools." [AR 47]. She also worked around 2003 as a daycare recruiting assistant doing paperwork and visiting people who needed assistance with bathing and other things. [AR 45-46].
Plaintiff started having back problems 13 years ago. [AR 47]. At first, doctors said it was just a vertebrae that had slipped out of place, but as it got worse they discovered it was "arthritis and stuff." [AR 47-48]. She has been taking Vicodin daily for five or six years. [AR 45]. She also takes Motrin and Soma, and explained that although Soma "can mess up my back" the doctors want her to take it at night "to help me to sleep with the pain in my back." [AR 45]. She said she takes the medication even though "it doesn't do anything really." [AR 50]. Asked by the ALJ if her doctor told her there was anything they could do about her back, she answered that right now she is just taking medication and is "waiting to go back to pain management to see if there's anything else they can recommend." [AR 49].
Plaintiff testified that she takes Cymbalta for her fibromyalgia, a condition she describes as causing "chronic pain all the time." [AR 50]. She said her doctor increased her Cymbalta dosage to two a day, but added that it "doesn't make a difference and so I take pain medication but it doesn't really do much good." [AR 50-51]. Plaintiff said her other problems are chronic fatigue, Epstein-Barr syndrome, insomnia, and hypertension. [AR 51]. Her hypertension is under control with medication, but the Epstein-Barr virus causes her pain and insomnia. [AR 51-52].
Plaintiff experiences pain and muscle spasms in her back. [AR 53]. She gets muscle spasms if she stands for more than five minutes. [AR 53, 55]. When she performs tasks with her hands, they may cramp up and go numb. [AR 54]. Plaintiff said that she can sit for 30 to 45 minutes and then has to stand for a few minutes. [AR 54]. Lying down and stretching her back two or three times a day helps with the pain. [AR 54-55]. She can lift two pounds. [AR 55].
Plaintiff explained that if she has errands to do, on some days she will "just get up and do them," but when the pain is really bad she postpones errands. [AR 48]. She tries to cook daily, but her son cooks if she is having a bad day. [AR 48]. She tries to clean daily, depending on how she feels. [AR 48, 56]. She does laundry, reads, and plays card and board games. [AR 48-49, 57]. She can go to the store and pick up her medication on her own. [AR 56]. She takes her son to and from school, but he does not go every day because he is "on an independent study." [AR 56]. She shops for groceries using a cart. [AR 56]. She does not have any problems bathing or getting dressed. [AR 57]. She drives a car, but her feet "cramp" about half the time when she drives. [AR 58]. She does not do yard work anymore. [AR 59].
Once a disability claimant produces evidence of an underlying physical or mental impairment that is reasonably likely to be the source of his or her subjective symptoms, the adjudicator is required to consider all subjective testimony as to the severity of the symptoms.
The ALJ concluded that plaintiff's answers to questions regarding her pain level indicated that she was exaggerating the severity of her symptoms "for secondary gain." [AR 28]. During the hearing, the ALJ asked plaintiff to rate her pain on a scale of zero to 10. [AR 49]. Plaintiff answered "10." [AR 49]. The ALJ replied, "[a] 10?," and then explained that "when we say 0 to 10[,] a 10 is like you want to jump out a window because you can't stand the pain. You're in agony, you're almost screaming." [AR 49]. Plaintiff followed by qualifying her answer as "[m]aybe about a seven on a daily basis." [AR 49].
Plaintiff contends that the ALJ improperly discredited her on the basis of her answers to those questions. [JS 12]. That contention has merit. Plaintiff revised her pain rating after the ALJ explained what a "10" rating meant to him. Her answers do not suggest that she was trying to exaggerate the extent of her pain.
An ALJ's reliance on an erroneous reason in making an adverse credibility determination is harmless "[s]o long as there remains substantial evidence supporting the ALJ's conclusions on credibility and the error does not negate the validity of the ALJ's ultimate credibility conclusion . . . ."
The ALJ's decision remains legally valid despite his error because he articulated additional particularized, clear, and convincing reasons for rejecting the alleged severity of plaintiff's subjective complaints. Specifically, the ALJ noticed that plaintiff "betrayed no evidence of pain or discomfort while testifying at the hearing until [she] was asked to describe the pain she experienced." [AR 28]. Plaintiff contends that it was improper for the ALJ to rely on his observations of her during the hearing. [JS 12]. Although generally not entitled to great weight, "[t]he inclusion of the ALJ's personal observations does not render the decision improper."
The ALJ also relied on plaintiff's inconsistent statements about why she stopped working. [JS 12]. The ALJ noted that plaintiff told the consultative psychiatric examiner, Dr. Andia, that she had stopped working as a preschool teacher due to excessive menstrual bleeding in 2005, but that plaintiff told the orthopedic consultative examiner Dr. Bilezikjian, that she stopped working as a preschool teacher in 2004 or 2005 because she was laid off. [AR 28, 232-233, 239-240]. Both statements are inconsistent with plaintiff's representations on her SSI application and disability reports that she became disabled on July 30, 2003. [
Finally, plaintiff challenges the ALJ's reliance on her daily activities. [JS 12-13, 17]. The ALJ noted that plaintiff stated in her disability reports and testimony that, on a typical day, depending on her pain, she played cards and board games [AR 48-49, 57, 168, 172]; ran errands when needed [AR 48, 168, 171, 233]; took her son to and from school (albeit not every day) [AR 56]; went grocery shopping regularly [AR 56]; spent one to one-and-a-half hours preparing meals on a daily basis [AR 48, 168, 170-71, 233]; did light housework, including washing dishes, ironing clothes, cleaning, laundry [AR 48, 168-170, 233]; drove a car [AR 163, 166, 233, 255]; ate out monthly [AR 172, 233]; visited her sister weekly [AR 172]; sent text messages daily [AR 171, 174]; read, swam, listened to music, and watched television [AR 168, 172, 233]; and cared for her adolescent son, including helping him with his homework [AR 29, 168-169, 233]. The ALJ also noted that plaintiff denied any problems with personal hygiene or personal care [AR 29, 56, 169, 233, 254]. The ALJ concluded that some of the physical and mental abilities and social interactions required to perform these activities are the same as those necessary for performing sedentary work. [AR 29]. The ALJ reasonably inferred that plaintiff's admitted ability to perform a fairly wide range of routine daily activities independently and without reporting significant interference or ill-effects from her allegedly disabling symptoms was one factor, among others, that justified rejecting the alleged severity of her subjective symptoms.
Because plaintiff fails to discuss, or even acknowledge, the ALJ's remaining reasons for finding her not credible, she has waived any challenge to these remaining aspects of the ALJ's credibility finding.
The ALJ was entitled to consider the other inconsistencies addressed in the decision. For example, the ALJ noted plaintiff's testimony that her medication "doesn't do anything really." [AR 28, 50]. The ALJ concluded that this was an "apparent exaggeration" because "[i]t is a reasonable conclusion that, despite her assertion to the contrary, the medication helped with her pain to some extent or else she would not have continued taking the medication." [AR 28]. This was a sensible inference from the record. Moreover, although plaintiff at times complained that her medication did not do anything, she also continued to seek and use it. [AR 218, 223-224, 266, 292-293, 298, 306, 320]. The ALJ could properly discount the believability of her testimony that the medication did not help considering she continued to ask for and use the medication.
The ALJ also permissibly considered plaintiff's statements to physicians that she continued to work as a preschool teacher until 2004 or 2005, after her alleged onset of disability. [
The ALJ found that plaintiff's credibility was further diminished because the alleged severity of her symptoms was inconsistent with her treatment history, in that plaintiff received "routine conservative treatment." [AR 29]. As discussed above, the fact that more aggressive treatment was not required, including surgical intervention or even a referral to a specialist, was inconsistent with plaintiff's allegations of a disabling condition. [AR 29]. During the hearing plaintiff testified that she was simply taking her medication and waiting to see if anything else could be recommended.
For the foregoing reasons, the ALJ's error in relying on the first factor did "not negate the validity of [his] ultimate credibility conclusion" and therefore was harmless.
Plaintiff contends that the ALJ erred in rejecting a third-party function report written by plaintiff's mother. [JS 17-18, 20-21].
While an ALJ must take into account lay witness testimony about a claimant's symptoms, the ALJ may discount that testimony by providing "reasons that are germane to each witness."
The ALJ noted that plaintiff's mother's statements mostly duplicated the subjective complaints reported by plaintiff. [AR 33]. The ALJ noted that, in fact, plaintiff's mother's statements appeared to be an almost verbatim recitation of the allegations from plaintiff's own function report.
Further, the ALJ noted that plaintiff's mother was not unbiased because she had a maternal and financial interest in ensuring that plaintiff received benefits in order to increase the household income. [AR 33]. Standing alone, a claimant's financial motivation for obtaining benefits is not a valid reason for discrediting the testimony of the claimant or family members.
Plaintiff contends that the ALJ improperly relied on the vocational expert's testimony because it is inconsistent with sedentary work and the
A claimant is "not disabled" if she retains the residual functional capacity to perform the "actual functional demands and job duties of a particular past relevant job" or the "functional demands and job duties of the occupation as generally required by employers throughout the national economy."
Plaintiff appears to contend that the RFC is inconsistent with the DOT because the full range of sedentary work entails sitting during most or all of an eight hour day. [JS 22]. Plaintiff misconstrues the ALJ's RFC finding, however. The ALJ did not find that plaintiff was able to work a full range of sedentary jobs. Rather, the ALJ found that plaintiff could perform a reduced range of sedentary work, in that she can lift and/or carry 10 pounds occasionally and 10 pounds frequently; she can stand and/or walk for two hours out of an eight-hour workday in 15 minute intervals; she can sit for six hours out of an eight-hour workday with regular breaks, but must stand every half hour for one minute before sitting back down; she cannot push and/or pull with the legs; she must avoid unprotected heights; she must avoid extreme cold; she must avoid climbing ladders but can occasionally climb stairs or ramps; she can occasionally stoop or bend; and she can occasionally perform overhead lifting.
[AR 26].
During the hearing, the vocational expert testified that a hypothetical person with plaintiff's vocational profile and the RFC ultimately adopted by the ALJ could perform alternate jobs that exist in significant numbers in the national economy, such as order clerk, food and beverage, DOT occupational classification number 209.567-014; optical assembler, DOT occupational classification number 713.687-018; and assembler, buttons and notions, DOT occupational classification number 734.687-018. [AR 62]. The ALJ specifically asked the vocational expert whether her testimony was consistent with the DOT, and she said that it was. [AR 62]. The ALJ relied on this testimony in finding plaintiff not disabled. [AR 33-34].
Plaintiff cites no authority demonstrating that the vocational expert's testimony is inconsistent with the three DOT jobs she identified. The DOT describes each of these occupations as sedentary work, which "involves sitting most of the time, but may involve walking or standing for brief periods of time."
For the reasons stated above, the Commissioner's decision is