KELLY K.E. MAHONEY, Chief Magistrate Judge.
Plaintiff Olivia K. Mikarovski seeks judicial review of a final decision of the Commissioner of Social Security (the Commissioner) denying her application for disability insurance (DI) benefits under Title II of the Social Security Act, 42 U.S.C. §§ 401-434. Mikarovski argues that an apparent conflict exists between her ability to only occasionally perform "overhead work," and the vocational expert (VE) testimony that she could perform jobs that require frequent reaching according to the Dictionary of Occupational Titles (DOT). Mikarovski also argues that the ALJ improperly discredited her subjective complaints without considering statements from her employers. Finally, Mikarovski raises (for the first time) an Appointments Clause challenge in reliance on Lucia v. SEC, 138 S.Ct. 2044 (2018). I recommend
Mikarovski began working at a hospital in 2002 as a surgical technician. AR 379.
Mikarovski filed for DI benefits at the suggestion of a vocational rehabilitation expert. AR 14, 379, 493. Shortly thereafter, in February 2015, a functional assessment ordered in connection with Mikarovski's worker's compensation claim confirmed that she could no longer perform medium or heavy work as required to be a surgical technician. See AR 368-72, 387, 520, 522. Mikarovski underwent another assessment of her functional abilities with John Kuhnlein, DO, in February 2015, but he did not complete his report until April 2015. AR 379-85. The hospital gave Mikarovski until the end of March to apply for and obtain a different position within the hospital. AR 520. Her job applications went unanswered, and the hospital terminated Mikarovski's employment on March 27, 2015. AR 503, 505. Her last three months of employment at the hospital, Mikarovski worked only light duty. See AR 300.
Mikarovski continued to receive worker's compensation benefits through October 2015. AR 501. She looked into the possibility of becoming a licensed in-home daycare provider, and in October 2015, she reported being paid to watch her grandson (she testified babysitting her grandson lasted for only a week). AR 54, 195, 573. In November 2015, Mikarovski reported that she had started working at JC Penney but had to leave on her second day. AR 575. In January 2016, she began working part time at Cato Fashions, a women's clothing store, as an assistant manager. AR 195. She continued to work at Cato Fashions through March 2017, when she obtained employment at CVS as a pharmacy technician. AR 205.
The Social Security Administration denied Mikarovski's application for DI benefits initially in September 2015 and on reconsideration in November 2015. AR 76-110. In connection with those reviews, state agency medical consultants Tracey Larrison, DO, and Jan Hunter, DO, evaluated Mikarovski's physical limitations, and state agency psychological consultants Aidaluz Tirado, PsyD, and Myrna Tashner, EdD, evaluated Mikarovski's mental limitations. AR 84-89, 102-107.
Mikarovski requested review before an ALJ, who held a video hearing on August 17, 2017, at which Mikarovski and a VE testified. AR 36-37. On November 13, 2017, the ALJ issued a written decision following the familiar five-step process outlined in the regulations
AR 19. Based on his determination of Mikarovski's RFC and the testimony of the VE, the ALJ found that Mikarovski could not perform her past work as a surgical technician but that other work existed in significant numbers in the national economy that Mikarovski could perform, such as an office helper, pricer, and routing clerk. AR 23-25.
Mikarovski appealed. The Appeals Council denied Mikarovski's request for review on June 28, 2018, (AR 5-7) making the ALJ's decision the final decision of the Commissioner. See
A court must affirm the ALJ's decision if it "is supported by substantial evidence in the record as a whole."
Mikarovski argues that the ALJ's finding she could perform other work is not supported by substantial evidence because the ALJ failed to resolve an inconsistency between the VE's testimony and the DOT. Mikarovski also argues that the ALJ's failure to consider statements submitted by her managers at Cato Fashions and CVS resulted in an erroneous RFC determination. Finally, Mikarovski argues that the ALJ's appointment to that position violates the Appointments Clause of the United States Constitution.
Once the ALJ determines that the claimant cannot perform her past work, the ALJ evaluates at step five whether the claimant can perform other work that "exist[s] in significant numbers in the national economy (either in the region where [the claimant] lives or in several regions in the country)."
In Moore, the Eighth Circuit held that the ALJ "improperly relied on the testimony of the VE without resolving [an] apparent conflict" between the VE's testimony and the DOT.
Mikarovski argues that Moore and Kemp dictate remand here. In his hypothetical to the VE and in his RFC determination, the ALJ limited Mikarovski to "occasional overhead work bilaterally." AR 19, 68. The VE testified (and the ALJ found) that a person with this limitation could work as an officer helper (DOT § 239.567-010), routing clerk (DOT § 222.687-022), or pricer (DOT § 229.587-018), all of which require more than occasional reaching according to the DOT (the officer helper and routing clerk positions require frequent reaching, and the pricer position requires constant reaching). AR 24, 69-70.
The Commissioner argues that "occasional overhead work bilaterally" (the limitation in claimant's RFC here) is distinguishable from "occasional overhead reaching" (the limitation in Moore and Kemp). The Commissioner argues that a limitation to occasional overhead work does not mean that a claimant is limited to occasional overhead reaching.
I disagree. "Overhead work" does not appear to be defined by the Social Security Administration or the DOT. But it defies common sense to say that Mikarovski could perform overhead work only occasionally, but that she could constantly perform work requiring overhead reaching—as the Commissioner argues. Work that requires overhead reaching necessarily seems to involve working overhead. A limitation to only occasional overhead work seems to encompass limitations to both overhead reaching and overhead lifting (as well as any other functional requirements involving working overhead).
District courts in the Eighth Circuit to address this issue have agreed. See
The Commissioner argues that the ALJ meant only to limit Mikarovski's ability to lift overhead, citing Dr. Kuhnlein's opinion. Dr. Kuhnlein opined that "Mikarovski could lift 30 pounds from floor to shoulder height, and 10 pounds occasionally over shoulder height," and that "[s]he could work occasionally at or above shoulder height because of the `moment arm' phenomenon in the lumbar spine with such activities." AR 384. The Commissioner notes the ALJ assigned partial weight to Dr. Kuhnlein's opinion and seemingly accepted his opinion regarding Mikarovski's physical restrictions. AR 22. The Commissioner argues that Dr. Kuhnlein did not assign any reaching restrictions to Mikarovski. Although true that Dr. Kuhnlein's opinion does not mention reaching, he limited Mikarovski's ability to work overhead, and it is not clear that he meant to include only lifting restrictions with this limitation. In any event, if the ALJ meant to limit only Mikarovski's ability to lift overhead, as the Commissioner argues, the ALJ could have specifically said so in his RFC determination, rather than limiting Mikarovski's ability to work overhead generally.
The Commissioner also argues that the state agency medical consultants' RFC opinions support that the ALJ did not intend to impose any reaching restriction. Although true that the state agency medical consultants found Mikarovski suffered no manipulative limitations, they did not limit Mikarovski's ability to work overhead in any manner. AR 84-86, 102-104. Consideration of the medical opinions does not change my interpretation of the ALJ's limitation involving overhead work.
I recognize that a few district courts outside the Eighth Circuit have held that a limitation involving overhead work does not necessarily mean that the claimant is limited in overhead reaching. See
2013 WL 4082714, at *4 (all but first two alterations in original) (footnote and citations omitted). The problem with the court's analysis is that the jobs it cites as examples of those involving overhead work all appear to require overhead reaching. And the DOT descriptions of the window washer, tree-trimmer, and wall-cleaner jobs all state they require frequent reaching. I am unconvinced that jobs exist that involve overhead reaching but do not require working overhead.
On this record, I find that the limitation to only occasional overhead work creates a possible conflict with the DOT description of jobs identified by the VE as requiring frequent reaching. I recommend that the district court remand to the Social Security Administration for the ALJ to recognize and resolve this apparent conflict through testimony from a VE.
Mikarovski's supervisors at the hospital, Cato Fashions, and CVS pharmacy completed assessment forms evaluating Mikarovski's work performance. See AR 205-08, 300-01. The ALJ did not discuss or cite these assessments in determining Mikarovski's RFC. See AR 19-23. Mikarovski argues that the ALJ's failure to do so resulted in the ALJ failing to assign her subjective complaints their due weight, which she argues were generally corroborated by her employers' assessment forms. See Doc. 18 at 5-7.
When evaluating the credibility of a claimant's subjective complaints—including pain or nervousness—the ALJ must consider the factors set forth in Polaski v. Heckler: "(1) the claimant's daily activities; (2) the duration, frequency and intensity of the pain; (3) dosage, effectiveness, and side effects of medication; (4) precipitating and aggravating factors; and (5) functional restrictions."
The regulations provide that the ALJ must consider opinions regarding a claimant's functional limitations from nonmedical sources and "generally should explain the weight given to opinions from these sources or otherwise ensure that the discussion of the evidence in the . . . decision allows a claimant or subsequent reviewer to follow the [ALJ's] reasoning, when such opinions may have an effect on the outcome of the case."
The work assessment form from the hospital rates Mikarovski's functional abilities in several categories on a five-point scale:
AR 300. The hospital also noted that while working light duty, Mikarovski complained to coworkers about her pain and the way the hospital treated her and overall, lacked a positive attitude. Id. The hospital noted Mikarovski left her work station often while working light duty. AR 301. The hospital noted it gave Mikarovski special considerations, including work in areas that significantly reduced standing, bending, and walking; and allowing for frequent absences (but not additional breaks, extra help or supervision, or shorter hours). Id.
Mikarovski's manager at Cato Fashions also completed a form evaluating Mikarovski's functional abilities on the job. AR 207-08. She noted that Mikarovski was not able to complete her job duties without special assistance and did not complete her work in the same amount of time as other employees in the same position, rating Mikarovski's productivity as 60% of similar employees. Id. She noted that Mikarovski received special assistance in several ways, including receiving fewer or easier duties, working irregular and less hours, taking more breaks or rest periods, having lower production standards, and receiving extra help (but not supervision). AR 207. She did not check that Mikarovski was allowed frequent absences but noted Mikarovski was frequently absent from work. AR 207-08. Mikarovski's manager at Cato Fashions concluded that Mikarovski came to work as scheduled but was often in pain, which made it difficult for her to stand and move as needed. AR 208. She noted that they tried to shorten Mikarovski's scheduled days to allow for her work time to be more comfortable and for her to be productive. Id.
Mikarovski's manager at CVS similarly noted that Mikarovski did not complete her job duties without special assistance, did not complete her work in the same amount of time as other employees in the same position (rating Mikarovski as 70% as productive as similar employees), and was frequently absent from work. AR 205-06. He noted that Mikarovski received special assistance in the form of fewer or easier duties, less hours, more breaks or rest periods, and extra help or supervision. AR 205.
The forms from Mikarovski's employers reflect on Mikarovski's functional abilities. The Commissioner argues that the statements "do not address plaintiff's functional abilities" (Doc. 21 at 9-10), but I disagree. That the statements from Cato Fashions and CVS were gathered for a different purpose—to determine Mikarovski's income, as the Commissioner argues—does not change that fact.
Mikarovski relies on Nowling v. Colvin, 813 F.3d 1110 (8th Cir. 2016), and Vantuyl v. Colvin, 985 F.Supp.2d 880 (N.D. Iowa 2013). In Nowling, the claimant's sister-in-law testified at the administrative hearing about her "interactions with [the claimant]," who she saw almost daily, "and her observations of [the claimant's] seizures." 813 F.3d at 1117. She testified to the frequency of the claimant's seizures and their average duration, as well as about the claimant's activities of daily living.
In Vantuyl, the other case Mikarovski relies upon, the ALJ "did not address the work performance assessment completed by [the claimant's] employer." 985 F. Supp. 2d at 893. The claimant's employer had completed a form indicating that the claimant's "work quantity/pace," "ability to carry out complex/detailed instructions and procedures," "ability to understand and carry out simple instructions, manage workplace stress[,] and manage personal stress while in the workplace" were poor, but other work-related functions were adequate or good.
This case is closer to Nowling than to Vantuyl. Here, the ALJ discredited the claimant's statements about her pain and limitations based in part on a finding of inconsistency with "her treatment records . . . show[ing] that the claimant's impairments are generally correctable with only conservative measures." AR 20. The ALJ cited treatment records from December 2014 through October 2015 in which providers determined surgery would not be beneficial for Mikarovski and objective examinations revealed normal neurological findings, including normal reflexes, normal coordination, and (mostly) normal strength; no spinal tenderness (at one appointment; the ALJ did not acknowledge that two other treatment records he cited reflected tenderness in Mikarovski's back); a negative straight leg raise test bilaterally (at one appointment; the ALJ did not acknowledge that another treatment record he cited reflected a positive straight leg test on the right side); and a normal range of motion in the lumbar spine at one appointment, but a limited range of motion in the back at two appointments (only one of the examinations reflecting a decreased range of motion was mentioned by the ALJ). See AR 20-21, 367, 449, 490, 545, 601.
Substantial evidence does not support the ALJ's conclusion that Mikarovski's symptoms were "correctable," nor that the "conservative" treatment she received was inconsistent with her complaints of pain. Although Mikarovski's providers ultimately determined that surgery would not improve Mikarovski's symptoms, Mikarovski tried just about every other type of treatment to help alleviate her pain, including:
In addition, Mikarovski has undergone five magnetic resonance imagings (MRIs) of her back in an attempt to diagnose the cause of her pain (AR 365-67, 394, 473-77, 716), consulted with multiple specialists in pain management (at two different pain clinics) and four different neurosurgeons (AR 365, 398, 410, 486, 536, 541, 607-08), and visited the emergency room due to back pain on two occasions (AR 599, 765). Despite this treatment, Mikarovski has never reported improved pain lasting for a significant amount of time (injections generally offered only short-term relief), and she has complained of back pain fairly regularly (at appointments seeking treatment for her pain, as well as at her mental-health and other appointments). See AR 489, 494, 501, 532, 536, 541, 547, 573-87, 599, 607, 612, 615-16, 643, 674, 677-92, 766-69, 778; but see 604, 720, 751. Substantial evidence does not support the ALJ's conclusion that Mikarovski's back pain improved with treatment. Neither should the ALJ have relied so heavily on the fact that Mikarovski's back impairment could not be corrected with surgery—this is not a case in which Mikarovski received little treatment; instead, as the ALJ recognized, her conservative treatment was extensive. AR 20-21, 23.
The ALJ gave other reasons for the weight assigned to Mikarovski's subjective complaints, pointing to the medical opinions in the record and a treatment record in which Mikarovski complained about having to be "on her feet for 8 hours at a time" for her job at CVS. AR 20-23, 587. But the work assessment form from Mikarovski's supervisor at CVS notes that Mikarovski was frequently absent from work, calling into question the ALJ's reliance on her ability to be on her feet for eight hours at a time, day in and day out, based on her work at CVS. AR 205-06. Although it appears Mikarovski could push through the pain some days, engaging in this level of activity caused her pain and to miss work on a regular basis.
Here, as in Nowling, the ALJ's failure to address the work assessment forms completed by Mikarovski's employers, coupled with other "errors and uncertainties" in the evaluation of Mikarovski's subjective complaints, leads to a conclusion that the ALJ erred by failing to address the work assessment forms and that this error was not harmless. Accordingly, I recommend that the district judge remand this case to the Social Security Administration for the ALJ to re-evaluate Mikarovski's RFC and subjective complaints in light of the work assessment forms completed by her employers and other deficiencies highlighted in this section.
The Appointments Clause of the Constitution requires that principal officers be appointed by the president with the advice and consent of the Senate and that inferior officers be appointed by "the President alone, . . . the Courts of Law, or . . . the Heads of Departments."
The Supreme Court held in Lucia that the five ALJs for the Securities and Exchange Commission (SEC) were inferior officers subject to the Appointments Clause.
Every judge in the Northern District of Iowa has addressed this issue and held that a claimant forfeits an Appointments Clause challenge by failing to raise it before the Social Security Administration (and have declined to excuse the forfeiture). See
Almost all Mikarovski's arguments have been previously addressed (and rejected) by other courts. I adopt the reasoning of these decisions (and of the majority of courts to address the issue). I recommend the district judge reject Mikarovski's Appointments Clause challenge. I would not preclude Mikarovski from raising an Appointments Clause challenge on remand, however. See, e.g.,
I recommend that the district court
Objections to this Report and Recommendation must be filed within fourteen days of service in accordance with 28 U.S.C. § 636(b)(1) and Federal Rule of Civil Procedure 72(b). Objections must specify the parts of the Report and Recommendation to which objections are made, as well as the parts of the record forming the basis for the objections.