ANDREW J. WISTRICH, Magistrate Judge.
Plaintiff filed this action seeking reversal of the decision of defendant Commissioner of Social Security (the "Commissioner") denying in part 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 parties are familiar with the procedural facts, which are summarized in the joint stipulation. [
The Commissioner's denial of benefits should be disturbed only if it is not supported by substantial evidence or is based on legal error.
Once a claimant is found disabled under the Social Security Act, a presumption of continuing disability arises that affects the burden of production.
20 C.F.R. §§ 404.1594(b)(1), 416.994(b)(1)(i).
Defendant contends that Bellamy has been "conclusively overruled by statutory amendment," and that the Commissioner does not have the burden of rebutting a presumption of continuing disability. [JS 23]. Defendant argues that the Social Security Disability Benefits Reform Act of 1984 ("Reform Act"), Pub. L. No. 98-460, 98 Stat. 1794 (effective October 9, 1984) amended 42 U.S.C. section 423(f), which governs the termination of disability benefits, to provide that "[a]ny determination made under this section shall be made on the basis of the weight of the evidence and on a neutral basis with regard to the individual's condition, without any initial inference as to the presence or absence of disability being drawn from the fact that the individual has previously been determined to be disabled." [JS 23].
In the circumstances of this case, defendant's argument lacks merit. Bellamy was decided after the statutory amendment that defendant claims abrogated it. Bellamy also has not been overruled or called into question by a decision of the Ninth Circuit or the United States Supreme Court. Notwithstanding the 1984 amendment of section 423(f), the Ninth Circuit and district courts within this circuit have continued to cite Bellamy for the proposition that a presumption of continuing disability applies when the Commissioner seeks to terminate disability benefits based on medical improvement.
Furthermore, the presumption of continuing disability does not create a substantive "inference" of continuing disability. Instead, it is an evidentiary presumption affecting the burden of production. When a presumption of continuing disability exists,
Defendant cited no case law supporting his contention that the Reform Act abrogated Bellamy. Nonetheless, there is some out-of-circuit authority for the proposition that a presumption of continuing disability is inconsistent with the language of section 423(f).
This court, of course, is bound by Ninth Circuit precedent. Furthermore, other courts outside this circuit have allocated the burden of proof in post-Reform Act cases under section 423(f) to the Commissioner, and have suggested that the Commissioner bears the burden of production.
Plaintiff argues that the ALJ's negative credibility assessment with respect to the period beginning May 15, 2009 was legally erroneous and was not supported by substantial evidence in the record.
Plaintiff underwent a left carpal tunnel release surgery in May 2007. In July 2007, arthroscopic surgery was performed on plaintiff's right knee. In October 2007, she underwent a right carpal tunnel release surgery. A second arthroscopic surgery on plaintiff's right knee was conducted in June 2008. She underwent a total right knee replacement in August 2008, and a total left knee replacement in March 2009. [AR 12; JS 7].
The ALJ found that plaintiff had severe impairments in the form of status post bilateral knee replacement surgeries, carpal tunnel syndrome status post bilateral carpal tunnel repair surgeries, and obesity. [AR 12]. The ALJ further found that plaintiff had the following additional medically determinable impairments that were not severe: well-controlled diabetes; hypothyroidism controlled with medication; rare occurrences of asthma with exertion, controlled with use of an inhaler; a resolved episode of cellulitis in her left leg; and a mild visual impairment. [AR 13].
The ALJ characterized plaintiff's statements regarding her subjective symptoms during the closed period as "generally credible." He noted that during that period, she underwent a total of six surgeries involving pre- and post-surgical evaluation, medical care, physical therapy, and a recovery period "during which [she] experienced pain and limited mobility and functionality of the affected area." [AR 14].
During the March 2010 administrative hearing, plaintiff was represented by counsel and testified on her own behalf. Plaintiff testified that she had a good result from both carpal tunnel release surgeries. Her dominant right hand was "pretty good," although "not as strong" as it used to be. Plaintiff said that she was getting "a little bit of the carpal tunnel back" in both hands, but "nothing severe." [AR 31-32].
Plaintiff testified that her recovery from her left knee replacement surgery in March 2009 was difficult and painful. She used a walker for about three months before she was able to walk unassisted. [AR 27-28, 41]. She said that she had fallen about four times in the year following her left knee surgery because she had trouble navigating steps or curbs. [AR 33]. Plaintiff also mentioned having a painful lump on her right knee; however, her doctor had run tests and told her "everything was fine." [AR 33-34].
Plaintiff testified that both knees tended to swell if she stood or sat for too long, or when it was cold. [AR 35-36, 37-38]. Plaintiff said that she took Norco or Lorcet [AR 36], both of which are brand names for the narcotic pain reliever hydrocodone with acetaminophen. [
Plaintiff testified that she could stand for about an hour and a half at a time and sit for about two hours at a time. [AR 37-38]. She said that she was uncomfortable when she had to get up from a seated position. [AR 37-38]. Asked if she could work an eight-hour day if she could alternate sitting and standing, plaintiff said there was "no way" because of pain in her legs and her back. She added that if she used her hands "for any length of time," they would go numb. [AR 38-39]. Plaintiff also said that she had low back pain that had started in approximately December 2008 and had been fairly steady since that time. [AR 39-40]. She reported that she had been diagnosed with arthritis of the spine, and that her pain medication did not help her lumbar pain. [AR 39-40].
Plaintiff gave her height as 5'4" and her weight as 225 pounds. She acknowledged that her doctors had told her to lose weight, but maintained that her thyroid disease made it harder to lose weight. [AR 40-41, 45]. Plaintiff testified that she did not use a cane, could drive, and did not have problems operating the foot pedals in a car. [AR 41].
Plaintiff said she had a "lesion" from arthritis on her right ankle that caused weakness, along with swelling in that ankle due to her most recent fall. She also testified that she had diabetic neuropathy in her hands and legs. [AR 42-44]. Plaintiff said that she could walk a block at a reasonable pace on a rough or uneven surface but that climbing, including stair-climbing, was very hard. [AR 42].
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.
In assessing the severity of plaintiff's subjective symptoms following the closed period, the ALJ permissibly considered "the lack of corroborating medical evidence documenting the severity of [her] symptoms and pain testimony." [JS 9].
The ALJ rationally concluded that because Dr. Simmons examined plaintiff "several months after her most recent surgery and after she completed her post-surgical recovery period" and was an orthopedic surgeon, his examination findings significantly undermined plaintiff's subjective allegations of disabling pain and other symptoms. The ALJ also observed that the treatment reports in the record pertaining to the period beginning May 15, 2009 did not corroborate plaintiff's subjective complaints of disabling symptoms in her knees, legs, or hands. Those reports consistently stated that plaintiff had normal musculoskeletal findings. [
Contrary to plaintiff's assertion, the ALJ did not base his credibility finding solely on the absence of medical evidence corroborating the alleged severity of her subjective complaints. The ALJ also took into account Dr. Simmonds' opinion that plaintiff was not precluded from performing a range of light work, and the absence of any conflicting treating source opinion. [AR 17, 426].
Giving some weight to plaintiff's testimony about her residual symptoms, and noting that Dr. Simmonds had not been "asked to perform a thorough evaluation of [plaintiff's] carpal tunnel syndrome or her shoulder impairment," the ALJ restricted plaintiff's RFC somewhat more than either Dr. Simmonds or the nonexamining physicians by including postural and manipulative limitations. [AR 15, 17].
The ALJ also observed that plaintiff's treatment reports for the period after her March 2009 surgery did not reflect subjective complaints of the severity she described in her testimony, or her alleged falls after the end of the closed period. [
The ALJ was entitled to draw a negative inference from the inconsistency between plaintiff's testimony regarding disabling pain, swelling, and tenderness during this period and the description of her subjective complaints in contemporaneous treatment reports.
The ALJ provided clear and convincing reasons for rejecting the alleged severity of plaintiff's subjective complaints with respect to the period beginning on May 15, 2009.
Accordingly, plaintiff's contentions are without merit.
Plaintiff argues that the ALJ's finding that plaintiff that plaintiff had limitations in handling and fingering was erroneous because the ALJ "did not assess the severity" of that restriction, and because no medical source imposed such a restriction.
The ALJ's RFC finding states that plaintiff is limited to "frequent" handling and fingering bilaterally, and the ALJ incorporated that limitation into a hypothetical question to the vocational expert. [AR 15, 47-48]. Therefore, neither his RFC finding nor his hypothetical question was incomplete or ambiguous in that respect.
Plaintiff's argument that the ALJ erred because he included in his RFC finding a functional limitation found in no medical source opinion is misguided. If that were the rule, the ALJ could never credit "excess" symptom testimony unless a medical source first credited that testimony and incorporated the limitation in question into a medical opinion.
Dr. Simmonds took a subjective history and examined plaintiff after the end of the closed period. He found no objective or clinical abnormalities that would warrant a restriction in handling or fingering, and he included no such limitation in his functional assessment. [AR 423-426]. The treatment records post-dating the closed period did not contain any medical source opinion reflecting such a limitation. Nonetheless, the ALJ was entitled to credit some of plaintiff's "excess" symptom testimony, and on that basis restrict plaintiff's RFC in ways that Dr. Simmonds did not. The ALJ did not err in this regard.
Plaintiff argues that the ALJ's finding of medical improvement is not supported by substantial evidence in the record.
The ALJ found that medical improvement occurred as of May 15, 2009 because: (1) plaintiff had not required any further surgeries since her left knee replacement surgery in March 2009; (2) plaintiff had not needed to use an assistive device to ambulate since her recovery from that surgery; and (3) treatment records documented improvement in her strength and range of motion in her knees as of that date. [AR 15].
A finding of medical improvement must be based on a decrease in the medical severity of plaintiff's impairments as of May 15, 2009 as reflected in improvement in the symptoms, signs or laboratory findings associated with plaintiff's impairments.
Similarly, evidence that plaintiff had not needed an assistive device to ambulate since recovering from her most recent knee replacement surgery was indicative of a decrease in the severity of her post-surgical symptoms.
Plaintiff's treatment notes from May 2009 through January 2010 also comprise substantial evidence supporting the ALJ's finding of medical improvement. As previously noted, beginning in May 2009, plaintiff's treatment providers documented normal musculoskeletal examination findings, with no significant subjective complaints related to her legs, hands, or wrists and no reports of continued use of an assistive device.
The ALJ pointed to evidence in the record showing that medical improvement related to the ability to work occurred as of May 15, 2009. Substantial evidence supports his finding that medical improvement occurred as of that date.
Plaintiff contends that the ALJ improperly relied on the vocational expert's testimony that a person who needed to change from sitting to standing every 60 minutes could perform plaintiff's past relevant work as a fast food worker. Plaintiff also contends that the ALJ did not properly resolve an apparent conflict between the vocational expert's testimony and information in the
A claimant is "not disabled" if he 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."
The ALJ posed a hypothetical question to the vocational expert positing an individual who, among other things, "should be allowed to change positions between sitting and standing every 60 minutes. . . ." [AR 47]. The vocational expert initially testified that the need to change positions every 60 minutes would preclude performance of plaintiff's past relevant work as a fast food worker, which she classified (in a written summary prepared before the hearing) as DOT job number 311.472-010. [AR 46, 156]. The VE immediately changed her testimony, however. She explained that some fast food workers "works the window, and they do sit, they have the capacity to sit. So I'm going to say that with eroded numbers . . . that position could be performed." [AR 48]. The vocational expert testified that the need to change positions would erode the occupational base of 400 jobs regionally and 100,000 jobs nationally by 90%, meaning that the hypothetical person could perform 10% of those jobs, that is, 10,000 jobs nationally. The vocational expert also testified that "there would be other work," but the ALJ did not ask her about other work. [AR 48-49].
The ALJ concluded that the vocational expert's testimony differed from information in the DOT. Citing a written statement in the record by the vocational expert explaining "[t]he reason for the different or inconsistent testimony," the ALJ adopted the vocational expert's testimony on the grounds that it was "reasonable and well-founded." [AR 18, 155].
Plaintiff portrays the vocational expert's testimony as ambiguous or unintelligible. The vocational expert's testimony was clear enough. She testified that the hypothetical person could perform the job of fast food worker with an erosion in the number of jobs available because of the need to be able to change positions every 60 minutes. She testified that there were some jobs in which a fast food worker worked at a window and therefore could sit down, giving the hypothetical person the opportunity to change positions as posited by the ALJ in his hypothetical question and RFC finding.
During the hearing, the ALJ did not ask the vocational expert whether her testimony conflicted with information in the DOT.
The vocational expert next explained her reasons for departing from the DOT and the SCO as follows:
[AR 155].
Plaintiff contends that the ALJ's explanation regarding the conflict between the vocational expert's testimony and the DOT was "vague" and "did not cite the apparently inconsistent testimony," and that the ALJ did not secure or provide a reasonable explanation for the conflict.
Plaintiff's arguments lack merit. The vocational expert's written statement is part of the record and specifies how and why her testimony departed from the DOT and the SCO. The ALJ cited that analysis in his decision to support his adoption of the vocational expert's testimony; he did not need to repeat it verbatim. The ALJ's decision also refers specifically to the conflicting testimony. [AR 18 ("The vocational expert testified that the requirement to alternate position between sitting and standing every 60 minutes would result in 90 percent erosion of the number of positions.")].
The vocational expert's stated reasons for deviating from the DOT and the SCO, moreover, were sufficient to justify the ALJ's reliance on her testimony. Neither the
For the reasons described above, the Commissioner's decision is supported by substantial evidence and free of legal error. Therefore, the Commissioner's decision is
The court's thorough review of the "ambiguous" and "inconclusive" statutory language and legislative history, relevant decisional authority, and other factors led it to conclude, among other things, that a claimant's failure to come forward with evidence that medical improvement related to the ability to work had not occurred could not be the basis for finding a closed period or terminating benefits, and that "forcing the claimant to attempt to prove a negative"—the absence of medical improvement related to the ability to work—was "fraught with logical, practical, and evidentiary problems."