RENÉE MARIE BUMB, District Judge.
Plaintiff John E. Hoag seeks review pursuant to 42 U.S.C. § 405(g) of the Commissioner of Social Security's (the "Commissioner's") final decision denying his claim for disability insurance benefits ("DIB") under the Social Security Act. Plaintiff filed a motion for summary judgment, and the Commissioner opposed that motion and filed a cross-motion for summary judgment. For the foregoing reasons, the Court affirms the Administrative Law Judge's ruling that Plaintiff was not disabled within the meaning of the Social Security Act during the relevant time period. Accordingly, the Court denies Plaintiff's motion and grants the Commissioner's cross-motion.
It appears that Plaintiff Hoag applied for DIB on May 31, 2005, alleging disability beginning May 3, 1999.
On October 4, 2007, the ALJ issued a decision finding that Plaintiff had the following severe impairments: lung cancer in remission, peripheral neuropathy, status post myocardial infarction, status post cerebrovascular accident, and a seizure disorder. (R. 16.) The ALJ found that despite these impairments, Plaintiff had the residual functional capacity to perform the full range of sedentary work through the date last insured, December 31, 2004. (R. 17.) Citing the vocational expert's testimony, the ALJ found that Plaintiff's residual functional capacity would not prevent him from performing his past sedentary work as a meter reader chief. (R. 20.) Thus, the ALJ concluded that Plaintiff was not under a disability as defined in the Social Security Act, at any time from May 3, 1999, the alleged onset date, through December 31, 2004, the date last insured. (R. 20.)
Plaintiff sought review of the ALJ's decision (R. 9-10), and on October 30, 2009, the Appeals Council denied Plaintiff's request (R. 5-8). Accordingly, the ALJ's decision became the final decision of the Commissioner for purposes of judicial review.
At the time of the ALJ hearing on June 26, 2007, Plaintiff was sixty-three years old, living with his wife, Marjorie Hoag, and receiving Social Security retirement insurance benefits. (R. 373, 381.) He testified that he worked as a meter reader supervisor until he developed lung cancer in May 1999. (R. 376.)
Plaintiff testified that after undergoing chemotherapy for lung cancer, he developed peripheral neuropathy ("PN"), a severe painful burning in his feet. (R. 380.) Although Plaintiff could not recall the date that the PN started, he testified that it began as a "minor discomfort" and eventually "progressed into constant burning" by the end of 2004. (R. 386-87.) He testified that sometimes the pain "doesn't bother [him] at all," and sometimes it is so painful that he is forced to take his shoes off and put his feet in a bucket of water. (R. 381.) However, Plaintiff later testified that in 2003, he experienced a burning sensation in his feet "pretty much every day." (R. 396.)
The ALJ questioned him about an office visit with Dr. Gorino on October 11, 2006, in which Dr. Gorino reported that Plaintiff "is exercising regularly, five days a week on a treadmill, and doing weights as part of a cardiovascular program." (R. 396.) Plaintiff conceded that he does use a treadmill and can walk half a mile (R. 396), although he later stated that he could only walk a block (R. 410).
Plaintiff also testified that he attends a special gym for people with health problems, approximately three to four times a week, (R. 381-82), and plays golf, usually riding a golf cart instead of walking, once or twice a week (R. 383).
He contended that prior to 2004, he had good days, when he could perform minor household chores, and bad days, when he could not. (R. 409.)
Although Plaintiff initially testified that he was prescribed Neurontin in 2003 only for his PN and not for seizures (R. 390-91), he later testified that it was prescribed to treat both his feet
He also testified that due to a stroke, he has difficulty walking up stairs. (R. 381.)
According to Plaintiff's wife's testimony, Plaintiff's PN started in 2000 and became progressively worse. (R. 412-13.) She stated that there were days in 2004 when he could not wear shoes and that he could only do light work around the house, but no yard work. (R. 413-14.) She reported that Plaintiff still had shortness of breath and, due to the effects of the stroke, his left leg was weak, and he had trouble getting up and down. (R. 415-16.)
Beth Kelly, the vocational expert, testified that Plaintiff's past work as a meter reader chief was skilled sedentary work as it generally exists, and light as performed by Plaintiff. (R. 419.)
Plaintiff underwent surgery to remove a malignant tumor from his right lung on May 3, 1999. (R. 85.) Dr. Michael J. Guarino, an oncologist, subsequently evaluated him on June 2, 1999. (R. 85-87.) Dr. Guarino again evaluated Plaintiff on April 21, 2004. He noted that there was no clinical evidence of tumor relapse since Plaintiff's completion of his cancer treatment four and a half years prior. (R. 84.) Six months later, Dr. Guarino reported that Plaintiff continued to display no clinical evidence of tumor activity. (R. 83.)
On October 12, 2005, Plaintiff reported that he was exercising three times per week and had some mild shortness of breath with exertion. (R. 250.) Following examination, Dr. Guarino reported that Plaintiff "continues to do well by his functional status" and should return for a follow-up examination in one year. (R. 250.)
On October 11, 2006, Plaintiff stated that as part of a cardiovascular program he was exercising five days per week on a treadmill and also lifting weights. (R. 249.) Dr. Guarino concluded that it had been seven years since Plaintiff's completion of his cancer treatment therapy and that he had no evidence of recurrent tumor activity. (R. 249.)
Dr. Biasotto, a family practice doctor, treated Plaintiff from December 1999 through Plaintiff's date last insured. (R. 336-348.) Importantly, on July 5, 2003, Plaintiff complained of burning and numbness in his feet, and Dr. Biasotto prescribed Neurontin. (R. 338.) The subsequent treatment notes reflect that Dr. Biasotto continued to prescribe Neurontin. (R. 336-38.) These notes also reflect that although Plaintiff subsequently complained of other problems through the date last insured, including arm and lower back pain, he did not complain of burning, numbness, or pain in his feet again. (R. 336-38.)
On January 11, 2006, over one year after Plaintiff's date last insured, Dr. Biasotto completed a medical impairment evaluation form for Plaintiff's social security application, which stated that Plaintiff's medical impairments were expected to result in death. (R. 229.) He also noted that Plaintiff's lung cancer, neuropathy, cerebral vascular accident (stroke), seizure disorder, and coronary artery disease had been "disabling" since 1999. (R. 229.) Dr. Biasotto noted that Plaintiff's impairments would prevent him from performing his past work as a meter reader chief and that his performance of this job could cause his death. (R. 230.)
He noted that walking, climbing, and usage of Plaintiff's lower extremities would aggravate Plaintiff's conditions (R. 230), but that Plaintiff's coronary artery disease and past lung cancer were under control (R. 231). Dr. Biasotto noted that Plaintiff's symptoms were an inability to walk due to neuropathy and shortness of breath due to his lung restrictions. (R. 232.) When asked to describe the signs, defined as "anatomical, physiological, or psychological abnormalities which are demonstrable, apart from [Plaintiff's] symptoms, by medically acceptable clinical diagnostic techniques," Dr. Biasotto responded with a "?" symbol. (R. 232.)
The attached "Physical Capacities Evaluation" indicates that in an eight-hour workday, Plaintiff can only sit for two hours and cannot stand or walk for any amount of time at all. It states that he can never lift or carry any weight, even under 10 pounds. (R. 234-35.)
Plaintiff had a seizure on July 28, 2002, and sought emergency treatment at Christiana Hospital. (R. 100.) Upon admission, testing revealed that Plaintiff was having a heart attack. (R. 100.) He underwent an emergency triple coronary artery bypass graft and tolerated the procedure well. (R. 100.) Jorge Serra, M.D., discharged Plaintiff on August 1, 2002, in stable condition. (R. 101.)
Plaintiff returned to Christiana Hospital just two days later on August 3, 2002, complaining of left underarm pain and back pain. (R. 136.) George Slupko, M.D., diagnosed upper arm and shoulder strain and discharged Plaintiff the following day. (R. 138.)
On December 19, 2002, Plaintiff returned to Christiana Hospital emergency department after becoming unable to use his left leg to stand or walk. (R. 151.) A magnetic resonance imaging (MRI) scan and a magnetic resonance angiogram (MRA) scan of Plaintiff's brain showed a hemorrhagic small stroke. (R. 151.) Plaintiff underwent physical therapy, and Dr. Biasotto discharged him on December 24, 2002, in stable condition with instructions to continue physical therapy. (R. 152.)
On October 25, 2003, Plaintiff returned to Christiana Hospital after having a seizure. (R. 200.) Dr. Kevin M. Boyle discharged Plaintiff on October 29, 2003, with instructions to seek follow-up treatment with various physicians. (R. 201-02.)
Dr. Boyle, a cardiologist, began treating Plaintiff following his heart attack in July 2002. On September 27, 2004, Plaintiff complained of feeling "wobbly" upon standing. (R. 122.) Dr. Boyle attributed this complaint to a change in Plaintiff's high blood pressure medication. (R. 122.) Upon examination, Plaintiff had no abnormalities in his extremities and voiced no other complaints. (R. 122.)
Four months after his date last insured, on April 7, 2005, Plaintiff reported feeling well and denied experiencing any chest pain or shortness of breath. (R. 119.) Once again, Plaintiff had no abnormalities in his extremities. (R. 119.)
Dr. Edelsohn, a neurologist, first treated Plaintiff in December 2002, after he had suffered a stroke. She examined Plaintiff again in July 2003. (R. 185-88.) Plaintiff denied having any focal neurological problems and reported taking Neurontin. (R. 186.) On examination, Plaintiff had normal muscle strength, intact sensory perception, and a normal ability to walk. (R. 187.) Plaintiff returned to see Dr. Edelsohn the following month and reported doing well. (R. 182.) He continued to have normal muscle strength and a normal ability to walk. (R. 183.)
On November 14, 2003, Plaintiff returned to see Dr. Edelsohn, after having suffered a generalized seizure during sleep the previous month. Dr. Edelsohn noted that because of his wife's good description of the seizure, Plaintiff had been started on Dilantin. (R. 180.) On examination, Plaintiff continued to have normal muscle strength, intact sensory perception, and a normal ability to walk. (R. 180.)
Plaintiff returned to Dr. Edelsohn on February 27, 2004, and reported that he was doing well. (R. 177.) Again, Dr. Edelsohn reported a normal ability to walk and normal muscle strength. (R. 178.) Dr. Edelsohn noted that Plaintiff "may return to driving for necessities only." (
On August 19, 2004, Plaintiff reported to Dr. Edelsohn that he continued to do well and that he had taken up golf and was getting exercise as a result of this activity. (R. 175.) Plaintiff continued to take Neurontin and on examination had good muscle strength, intact sensory perception, and a normal ability to walk. (R. 176.)
On March 8, 2005, just two months after the date last insured, Plaintiff reported doing "extremely well" and that he continued to use Neurontin. (R. 173.) Dr. Edelsohn noted that his "only complaint" was "a feeling of unsteadiness when he first stands." (R. 173.) Again, he retained normal muscle strength and also had a normal ability to walk. (
Robert Palandjian, D.O., a state agency physician, reviewed the evidence of record and completed a physical residual functional capacity assessment form on August 27, 2005. (R. 237-44.) Dr. Palandjian found that Plaintiff could lift ten pounds occasionally, less than ten pounds frequently, could stand and/or walk at least two hours during an eight-hour workday, and sit about six hours during an eight-hour workday. (R. 238.) He also found that Plaintiff could never climb ladders, rope, or scaffolds, could occasionally climb ramps and stairs, could occasionally kneel, crouch, and crawl, could frequently stoop, needed to avoid concentrated exposure to humidity, and needed to avoid even moderate exposure to temperature extremes, environmental pollutants, and hazards. (R. 241.)
When reviewing a final decision of the Social Security Commissioner, the Court must uphold the Commissioner's factual decisions if they are supported by "substantial evidence." 42 U.S.C.§§ 405(g), 1383(c)(3);
Where the Commissioner is faced with conflicting evidence, however, "he must adequately explain in the record his reason for rejecting or discrediting competent evidence."
While the ALJ must review and consider all pertinent medical and non-medical evidence and "explain [any] conciliations and rejections,"
In addition to the substantial evidence inquiry, this Court must also review whether the administrative determination was made upon application of the correct legal standards.
The Social Security Act defines "disability" as the inability "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 twelve months." 42 U.S.C. § 1382c(a)(3)(A). The Act further states,
42 U.S.C. § 1382c(a)(3)(B).
The Commissioner has promulgated a five-step, sequential analysis for evaluating a claimant's disability, as outlined in 20 C.F.R. § 404.1520(a)(4)(i)-(v). In
Plaintiff Hoag argues that the ALJ erred in concluding that he is not disabled within the meaning of the Social Security Regulations. (Pl.'s Br. 4.) He now seeks an award of attorney's fees
"A cardinal principle guiding disability eligibility determinations is that the ALJ accord treating physicians' reports great weight, especially `when their opinions reflect expert judgment based on a continuing observation of the patient's condition over a prolonged period of time.'"
20 C.F.R. § 404.1527(d)(2)(emphasis added). The regulations also provide that when the ALJ does not give the treating source's opinion controlling weight, it will determine the weight to give the medical opinion based on several factors, including (1) the length of the treatment relationship and frequency of examination; (2) the nature and extent of the treatment relationship; (3) the degree to which the medical opinion is supported with relevant evidence, including medical signs and laboratory findings; (4) the degree to which the opinion is consistent with the record as a whole; (5) the doctor's specialization and whether his opinion relates to his area of specialty; and (6) other factors, which the claimant or others brings to the Commissioner's attention. 20 C.F.R. §§ 404.1527(d)(2)(i-ii) & (d)(3-6).
Thus, "the opinion of a treating physician is to be given controlling weight
In
Similarly, here, the ALJ did not disregard Dr. Biasotto's medical source statement, as Plaintiff contends (Pl.'s Br. 9), but merely determined that it should not carry
The ALJ determined that this medical source statement was not supported by Dr. Biasotto's treatment records, because after "scouring" them, she found only one mention of PN. (R. 19.) This occurred on July 5, 2003, when Plaintiff complained of bilateral foot burning and numbness, and Dr. Biasotto diagnosed the condition as PN and prescribed Neurontin. (
The Court notes that "[t]he ALJ is not required to use particular language or adhere to a particular format in conducting h[er] analysis. Rather, there must be sufficient development of the record and explanation of findings to permit meaningful review."
The Court further notes that like the
The Court also notes that Dr. Biasotto's opinion was not supported by any medically acceptable clinical and laboratory diagnostic techniques, which is necessary to warrant "controlling" weight.
Thus, the ALJ's well-reasoned, well-supported opinion provides an adequate explanation for her decision to give limited weight to Dr. Biasotto's opinion. After reviewing the record evidence, the Court is also satisfied that the ALJ's decision is supported by substantial evidence.
Plaintiff also argues, in passing, that the ALJ "failed to properly analyze and apply . . . Dr. Edelsohn's opinions[.]" (Pl.'s Br. 12-13.) The Court notes that Dr. Edelsohn's "opinions" consist of a two-sentence letter, merely stating that Plaintiff "was prescribed Neurontin to control symptoms related to a neuropathy." (Ex. 25F, R. 327.) Again, it appears that the ALJ diligently reviewed and analyzed the record. She notes that although Dr. Edelsohn claims that Plaintiff was prescribed Neurontin for neuropathy, "there were no complaints of neuropathy in the 25 pages of Dr. Edelsohn's records." (R. 19.) This Court's review of the record supports the ALJ's determination that Dr. Edelsohn never mentioned Plaintiff's PN in his treating notes. (R. 173-87.) As discussed above, Dr. Edelsohn's treatment notes reflect that Plaintiff had normal muscle strength, intact sensory perception, and a normal ability to walk, and that he reported doing well and playing golf.
Finally, Plaintiff cursorily asserts that the ALJ did not adequately consider his testimony or the pharmaceutical records, which substantiate his treatment of PN and Dr. Biasotto's assessment. (Pl.'s Br. 4, 12-13.) Again, the Court disagrees.
An ALJ "must give weight to a claimant's testimony `when this testimony is supported by competent evidence.'"
Here, the ALJ found that while Plaintiff's "medically determinable impairments could have been reasonably expected to produce some of the alleged symptoms," the couple's testimony regarding the "intensity, persistence and limiting effects" of these symptoms was "not entirely credible." (R. 19.) After assessing the record, she concluded that Plaintiff and his wife "either exaggerated the effects of PN or are misremembering when the severity developed which they are claiming went back as far as his date last insured." (R. 19.) The ALJ reasoned that since Plaintiff "must show a residual functional capacity below the sedentary exertional level in order to prevail, he is now alleging severe, intractable, PN of the feet, so severe he could not even do the limited walking required by sedentary work." (
The Court finds that the ALJ adequately articulated her reasons for finding Plaintiff's and his wife's testimony not entirely credible. The Court also finds this assessment supported by substantial evidence in the record. The ALJ appears to have thoroughly and thoughtfully considered the record, vigorously questioned Plaintiff at the hearing, and highlighted relevant parts of the record in her opinion. As discussed above, the record reflects that Plaintiff only complained of his PN once before the date last insured and that he did not have the type of severe pain he now claims he suffered at the time.
Finally, Plaintiff argues that the ALJ erred by reaching her conclusions "without citation to or discussion of the pharmaceutical records supplied to substantiate Hoag's treatment of PN." (Pl.'s Br. 13.) However, "[t]here is no requirement that the ALJ discuss in its opinion every tidbit of evidence included in the record."
In any case, the Court disagrees with Plaintiff's characterization of the ALJ's opinion. Although the ALJ does not cite the actual exhibit listing Plaintiff's pharmaceutical records, it is quite clear that she did consider Plaintiff's treatment with Neurontin. (
Accordingly, for the reasons discussed above, the Court finds that the ALJ's decision is supported by substantial evidence and is affirmed. An accompanying Order will issue this date.