JOHN C. NIVISON, Magistrate Judge.
On Plaintiff Lynn C.'s application for disability insurance benefits under Title II of the Social Security Act, Defendant, the Social Security Administration Commissioner, found that Plaintiff has severe impairments, but retains the functional capacity to perform substantial gainful activity. Defendant, therefore, denied Plaintiff's request for disability benefits. Plaintiff filed this action to obtain judicial review of Defendant's final administrative decision pursuant to 42 U.S.C. § 405(g).
Following a review of the record, and after consideration of the parties' arguments, I recommend the Court affirm the administrative decision.
The Commissioner's final decision is the November 9, 2016, decision of the Administrative Law Judge. (ALJ Decision, ECF No. 6-2.)
The ALJ found that Plaintiff has severe, but non-listing-level impairments consisting of "other and unspecified arthropathies," diabetes mellitus, peripheral neuropathy, and dermatitis. (ALJ Decision, R. 26, 29, ECF No. 6-2.) In her step 2 discussion, the ALJ concluded that Plaintiff has several non-severe impairments, including carpal tunnel syndrome and psoriatic arthritis.
Based on the RFC finding, Plaintiff's age on the date of hearing (52 years), Plaintiff's education and vocational background, and the testimony of a vocational expert, the ALJ determined that Plaintiff is capable of performing past relevant, sedentary work as an appointment clerk in a call center. (R. 35.) Accordingly, the ALJ found Plaintiff was not disabled through the date of the ALJ's decision, and denied Plaintiff's claim. (R. 35-36.)
A court must affirm the administrative decision provided the decision is based on the correct legal standards and is supported by substantial evidence, even if the record contains evidence capable of supporting an alternative outcome. Manso-Pizarro v. Sec'y of HHS, 76 F.3d 15, 16 (1st Cir. 1996) (per curiam); Rodriguez Pagan v. Sec'y of HHS, 819 F.2d 1, 3 (1st Cir. 1987). Substantial evidence is evidence that a reasonable mind might accept as adequate to support a finding. Richardson v. Perales, 402 U.S. 389, 401 (1971); Rodriguez v. Sec'y of HHS, 647 F.2d 218, 222 (1st Cir. 1981). "The ALJ's findings of fact are conclusive when supported by substantial evidence, but they are not conclusive when derived by ignoring evidence, misapplying the law, or judging matters entrusted to experts." Nguyen v. Chater, 172 F.3d 31, 35 (1st Cir. 1999).
Plaintiff argues the decision is not supported by substantial evidence because the ALJ erroneously found that psoriatic arthritis and carpal tunnel syndrome are not severe impairments. Plaintiff observes that appropriate consideration of the limitations associated with the conditions (specifically, Plaintiff's ability to handle objects) would rule out a return to past relevant work, and that a restriction to sedentary work would dictate a finding of disabled under Defendant's Medical-Vocational Guidelines.
At step 2 of the sequential evaluation process, a claimant must demonstrate that he or she has impairments that are "severe" from a vocational perspective, and that the impairments meet the durational requirement of the Social Security Act. 20 C.F.R. § 416.920(a)(4)(ii). The step 2 requirement of "severe" impairment imposes a de minimis burden, designed merely to screen groundless claims. McDonald v. Sec'y of HHS, 795 F.2d 1118, 1123 (1st Cir. 1986). An impairment or combination of impairments is not severe when the medical evidence "establishes only a slight abnormality or combination of slight abnormalities which would have no more than a minimal effect on an individual's ability to work even if the individual's age, education, or work experience were specifically considered." Id. at 1124 (quoting Social Security Ruling 85-28). In other words, to constitute a severe impairment, the impairment must have more than a minimal impact on the claimant's ability to perform basic work activities on a regular and continuing basis. Id.
At step 2, medical evidence is required to support a finding of severe impairment. 20 C.F.R. § 404.1521. See also Social Security Ruling 96-3p ("Symptoms, such as pain, fatigue, shortness of breath, weakness, or nervousness, will not be found to affect an individual's ability to do basic work activities unless the individual first establishes by objective medical evidence (i.e., signs and laboratory findings) that he or she has a medically determinable physical or mental impairment(s) and that the impairment(s) could reasonably be expected to produce the alleged symptom(s).") (citation omitted). A diagnosis, standing alone, does not establish that the diagnosed impairment would have more than a minimal impact on the performance of work activity. Dowell v. Colvin, No. 2:13-cv-00246-JDL, 2014 WL 3784237, at *3 (D. Me. July 31, 2014). Moreover, severe impairments may be deemed non-severe through the ameliorative influence of medication and other forms of treatment. Parsons v. Astrue, No. 1:08-cv-218-JAW, 2009 WL 166552, at *2 n.2, aff'd, 2009 WL 361193.
The ALJ found the impairment related to Plaintiff's carpal tunnel syndrome was not severe because Plaintiff's physical examinations were "negative for limitation of motion, atrophy, decreased strength, and upper extremity motor, sensory, or reflex loss." (R. 28, citing Exs. 1F, 3F, 4F, 5F, 16F.)
Arthur Scott, M.D., a consultative examiner, assessed a decreased ranged of motion in both wrists and a loss of strength in the right hand. (Ex. 5F, R. 295-96.) Additionally, an EMG report prepared by Christopher Hughes, M.D., reflects "prolonged distal latency and "mild to moderate" (left) and "moderate" (right) "slowing through the carpal tunnel." (Ex. 1F, R. 247.) The findings, however, do not necessarily establish that the condition has more than a miminal impact on Plaintiff's ability to perform basic work activities. The overall record, including the absence of a surgery recommendation, Plaintiff's July 2016 report to Dr. Hughes that numbness in her hands is better when she wears her braces (Ex. 16F), Dr. Hughes' related, recent neurology exam, which fails to identify any motor limitations in Plaintiff's hands, and the assessment of Tom Dees, M.D., a consultative expert, who found no limitations caused by carpal tunnel syndrome,
The ALJ recognized that rheumatologist Brian Keroack, M.D., diagnosed psoriatic inflammatory arthritis in 2008 (Ex. 13F), but questioned the significance of the diagnosis because the symptom at the time was limited to "a swollen finger on the right hand, and not on serologic findings." (R. 27.) The ALJ concluded that other references to the diagnosis merely reflect that the diagnosis continued in the medical history, but the record since 2008 includes no other documented joint swelling and/or synovitis, or other supportive diagnostic findings. (Id.)
Plaintiff argues the more recent records reinforce and demonstrate the significance of the diagnosis, which records include the consultative exam of Dr. Scott (Ex. 5F), a January 20, 2015 progress note from Leonic Temken, M.D. (Ex. 4F:1), and an October 30, 2015 progress note from Steven Petrin, N.P. (Ex. 10F:2). Plaintiff also contends Disability Determination Services consulting physicians did not review all of the relevant medical records related to psoriatic arthritis, specifically Dr. Keroack's diagnosis and Nurse Practitioner Petrin's progress note. Plaintiff further argues that both the consultative examiner, Dr. Scott, and Plaintiff's provider, Christine Sullivan, M.D., would impose restrictions related to handling and lifting based on the arthritis. (Statement of Errors 2.) Finally, Plaintiff notes that Dr. Keroack found she was allergic to the preferred medications. (Id.; Ex. 13F.)
Plaintiff alleges an onset of disability in August 2014. (Fact Sheet, ECF No. 8.) The ALJ permissibly concluded that Plaintiff had failed to demonstrate that the 2008 diagnosis for psoriatic arthritis in her right hand was a severe impairment in the relevant time period. First, the mere fact Dr. Keroack diagnosed the condition in 2008 is insufficient, without more, to support the conclusion of a severe impairment. The evidence that supports the ALJ's determination consists of the October 2015, expert opinion of Dr. Dees, who reviewed the medical record, including Dr. Keroack's diagnosis, for Disability Determination Services and specifically noted there was "[n]o confirmation of arthritis in hands" and that "[t]he actual findings of arthritis are minimal in knees, nonexistent in hands."
Based on the foregoing analysis, I recommend the Court affirm the administrative decision.