MAX O. COGBURN, Jr., District Judge.
Plaintiff applied for disability and disability insurance benefits in November 2012, alleging that he became disabled on September 15, 2009. (Tr. 10). Her claim was denied at the initial and reconsideration levels of review. (Tr. 10). Plaintiff filed a timely request for a hearing before an Administrative Law Judge ("ALJ"). A hearing was held before Theodore W. Grippo, an ALJ, on August 14, 2014, at which plaintiff had an attorney representative present. (Tr. 26). In a November 26, 2014 written decision, the ALJ denied the plaintiff's claim. (Tr. 16-27). Plaintiff requested review of the ALJ's decision. (Tr. 10-12). The request for review was denied by the Appeals Council on December 1, 2015 (Tr. 1), rendering the ALJ's decision the final decision of the Commissioner.
The ALJ's findings of fact are adopted and incorporated herein as if fully set forth. Such findings are referenced in the substantive discussion which follows.
The only issues on review are whether the Commissioner applied the correct legal standards and whether the Commissioner's decision is supported by substantial evidence.
The court has read the transcript of plaintiff's administrative hearing, closely read the decision of the ALJ, and reviewed the relevant exhibits contained in the extensive administrative record. The issue is not whether a court might have reached a different conclusion had it been presented with the same testimony and evidentiary materials, but whether the decision of the administrative law judge is supported by substantial evidence. The court finds that the ALJ's decision in large part was supported by substantial evidence. Nonetheless, the court is "left to guess" in part and must refrain from re-weighing evidence here.
A five-step process, known as "sequential" review, is used by the Commissioner in determining whether a Social Security claimant is disabled. The Commissioner evaluates a disability claim under Title XVI pursuant to the following five-step analysis:
20 C.F.R. § 416.920(a)-(f). The burden of proof and production during the first four steps of the inquiry rests on the claimant.
At step one, the ALJ found that the plaintiff had engaged in substantial gainful activity during the months of January to March in 2011. (Tr. 12).
The ALJ concluded that the plaintiff had the residual functional capacity (RFC) to perform medium work, with several limitations. (Tr. 15). The RFC's limitations included only occasionally climbing ladders, ropes, and scaffolds, and frequently climbing ramps and stairs.
At step four, the ALJ found that plaintiff Hartsog could perform his past relevant work. (Tr. 20). Accordingly, the ALJ determined that the plaintiff had not been under a disability within the meaning of the Social Security Act, 20 C.F.R. 404.1520(g), from the application date September 15, 2009 to the date of the decision. (Tr. 26).
The court has closely read plaintiff's Memorandum of Law (#8-1) supporting his Motion for Summary Judgment. Plaintiff has made the following assignments of error:
(#8-1) at 4. Plaintiff's assignments of error will be discussed seriatim below.
Plaintiff claims that he filed a subsequent application for disability and was found disabled as of November 14, 2014. (#8-1) at 5. He then asserts that that subsequent application requires remand in the instant case.
Plaintiff argues that "there is no other explanation for the [subsequent disability] approval except that State Agency experts confirmed impairments and opined limitations which they concluded prohibited all substantial, gainful employment, a single day after the ALJ came to the opposite conclusion." (#8-1) at 5. Plaintiff relies heavily upon
Plaintiff's argument is that a subsequent favorable determination, close in time to the original unfavorable determination,
Inter alia, the plaintiff contends that the ALJ himself cited a "lack of medical evidence" as justifying his determination of plaintiff's RFC. (#8-1) at 6,
Ultimately, the role of the court in cases like this is not to re-weigh the evidence or conduct a de novo review. Instead, the court asks whether the ALJ based his or her determination upon substantial evidence. Here, the ALJ did so and provided reasoning sufficient to facilitate judicial review. Moreover,
Plaintiff next contends that the ALJ's determination that the plaintiff could return to his past work was not based on substantial evidence. (#8-1) at 6. Plaintiff's assertions are three-fold. First, plaintiff asserts that the ALJ ignored limitations regarding the plaintiff's hands. (#8-1) at 9. Second, the plaintiff argues that the ALJ ignored the impact of plaintiff's leg swelling and risk of deep vein thrombosis. (#8-1) at 14. Third, plaintiff contends that the ALJ ignored limitations stemming from plaintiff's cataract, affective disorder, and COPD. (#8-1) at 19.
Taking plaintiff's first argument first, plaintiff argues that the ALJ did not adequately discuss and take into account plaintiff's impairments with his hands. The ALJ cited to treatment records from Dr. Li and that the "medical evidence of record does not indicate significant problems with the left hand after surgery." (Tr. 18).
Regarding plaintiff's hands, the ALJ further noted an examination in 2013 where the plaintiff's hand strength was rated 4/5 and his allegation of bilateral hand pain was assessed. (Tr. 18-19). The ALJ also noted an August 2014 visit with a physician who listed "Dupuytren's contracture" within the problem list. (Tr. 19). The ALJ also reviewed a third party function report that noted that plaintiff, among other things, is able to "wash dishes" and "use a computer." (Tr. 19).
Plaintiff's allegations also stem from his testimony before the ALJ regarding his alleged hand-related impairments. The ALJ noted that the plaintiff's testimony included symptoms of hand pain. (Tr. 16). Even so, the ALJ found that the intensity, persistence, and limiting effect of plaintiff's alleged symptoms, including his hand pain, were "not entirely credible." (Tr. 16). The ALJ's determination and evaluation of the record does not "ignore" plaintiff's limitations with his hands. It is clear from the ALJ's opinion that he reviewed plaintiff's testimony and records from Dr. Li and others regarding plaintiff's hands. It is not for the court to re-weigh the evidence or find that the ALJ should have decided differently. Instead, the court must inquire as to whether the ALJ's reasoning was based on substantial evidence. Here, the court so finds.
Plaintiff's second argument relates to leg swelling and risk of deep vein thrombosis and contends that the ALJ simply "ignored" the impact of these impairments.
It is clear that the ALJ did not "ignore" alleged impairments related to plaintiff's legs, particularly related to deep vein thrombosis, in crafting his RFC determination. The ALJ cited multiple sections of the record evidence related to plaintiff's legs. Accordingly, remand will be granted on this basis as the ALJ showed his work and based his determination upon substantial evidence.
Plaintiff's third argument relates to the assessment of plaintiff's cataracts, COPD, and affective disorder. Plaintiff contends that these impairments were "wrongfully ignored" by the ALJ. (#8-1) at 19.
At step two, the ALJ discussed the reports of the physical consultative examiner as well as two other doctors regarding plaintiff's cataract. (Tr. 13). Ultimately, the ALJ found, based on the record evidence, that the alleged cataract was not a severe impairment. In his RFC analysis, the ALJ also noted that plaintiff's vision was measured at 20/100 in both eyes in March 2013. (Tr. 19).
Similarly, the ALJ's step two analysis discussed plaintiff's allegations of affective disorder. In making his determination as to plaintiff's alleged affective disorder, ALJ noted the opinion of the State Agency psychological examiner and the ALJ's own review of the paragraph B criteria. (Tr. 13-14). Upon review of the record, the ALJ found that plaintiff's medically determinable mental impairment has resulted in no episodes of decompensation and no more than a "mild" limitation on his activities of daily living, social functioning and concentration, persistence, or pace. (Tr. 14). In the RFC analysis, ALJ also referred to the opinion of the State Agency psychological consultant regarding plaintiff's "nonsevere" mental impairments. (Tr. 19).
The ALJ amply reviewed plaintiff's COPD, which was found to be a severe impairment at step two. (Tr. 13). Among other things, the ALJ reviewed records that noted that the plaintiff suffered from "chronic tobacco dependence," "chronic cough," and "shortness of breath." (Tr. 18-19). Spirometric testing reviewed by the ALJ noted that the plaintiff had a pre-bronchodilator FEV1 score of 75% of predicted. (Tr. 19).
The plaintiff alleges error in that the ALJ "offered no explanation" as to why plaintiff's COPD "did not translate into at least some environmental limitation in the RFC." (#8-1) at 20. The ALJ noted that the claimant had a wide range of activities of daily living, including that the plaintiff could ride a bike, prepare meals, mow the lawn, water the flowers, shop in stores, and other similar activities. (Tr. 19). The ALJ specifically noted that the activities of daily living supported the RFC finding. (Tr. 19). In doing so, the ALJ provided at least some reason as to why an environmental limitation was not included in the RFC—the ALJ considered such a restriction unnecessary given plaintiff's activities of daily living, among other aspects of the record. Accordingly, remand cannot be granted on this ground.
Plaintiff further asserts that the ALJ's credibility determination was not supported by substantial evidence. (#8-1) at 20. In particular, plaintiff argues that it was improper for the ALJ to use plaintiff's attempt to return to work against him. (#8-1) at 20. Plaintiff also contends that the ALJ erred by holding plaintiff's failure to obtain medical care against him, "cherry-picking" evidence from a questionnaire, and the ALJ's "specious" use of the "perceived delay" in plaintiff's application for benefits and his alleged onset date. (#8-1) at 22-25.
Plaintiff asserts that it was improper for the ALJ to use plaintiff's return to work from January to March, 2011 against him. (#8-1) at 20. 20 C.F.R. § 404.1574(c) establishes that work which lasts six months or less "will" be considered an "unsuccessful work attempt" if an individual stops working because of their impairment. 20 C.F.R. § 404.1574(c)(3). SSR 84-25 makes clear that the concept of an "unsuccessful work attempt" is applicable to an initial disability case. Likewise, SSR 05-02 provides that "`earnings from an unsuccessful work attempt [lasting three months or less] will not show that you are able to do substantial gainful activity.'" SSR 05-02 (quoting 404.1574(a)(1), 416.974(a)(1)). Before beginning a work attempt which later proves unsuccessful, there must be a break in the continuity of one's work of at least thirty days. SSR 05-02.
In the instant case, plaintiff returned to work as automobile mechanic for a brief period from January to March, 2011 after not working for almost two years. (Tr. 12, 33-36). Plaintiff alleges that he left this position after this two-month attempt because he was unable to perform it satisfactorily. (Tr. 33-36). Plaintiff specifically cited difficulties with required postures, extensive standing which resulted in swelling, constant pain, inability to get on his knees, and difficulty lifting due to contractures in his hands as reasons for leaving the position. (Tr. 33-36).
In his decision, the ALJ did not discuss plaintiff's reasons for leaving this position after two months, but rather asserted that plaintiff's work as an automobile mechanic constituted substantial gainful activity because plaintiff earned $1,998.63 per month. (Tr. 17). The ALJ considered this two-month attempt as activity which was inconsistent with plaintiff's alleged symptoms and limitations in this case. (Tr. 17). The ALJ noted that this work history reduces plaintiff's credibility. (Tr. 17). However, as SSR 05-2 makes clear, the earnings from a work attempt lasting less than three months or less due to impairments or limitations "`will not show that you are able to do substantial gainful activity.'" SSR 05-02 (quoting 404.1574(c), 416.974(c)).
It is not the province of the court to engage in fact-finding exercises in the first instance or re-weigh conflicting evidence.
In his discussion of plaintiff's medical history, the ALJ noted that the plaintiff rejected a physician's recommendation to have surgery on his back in October of 2012. (Tr. 18). The ALJ found that this rejection gave reasons to question plaintiff's credibility. (Tr. 17-19). Plaintiff asserts that the ALJ improperly failed to consider that plaintiff was uninsured from August 28, 2012 until May 2, 2014 in his assessment of plaintiff's credibility. (#8-1) at 22-23. Plaintiff argues that 20 C.F.R. § 404.1529 and SSR 96-7p require an ALJ to consider an individual's insured status when discussing their rejection of treatment. (#8-1) at 23. The court is unable to find such a requirement in the regulations cited by plaintiff. However, In
20 C.F.R. 404.1530(a)-(b). The regulations list the following "good reason[s] for not following treatment:
20 C.F.R. 404.1530(c). Social Security Ruling 82-59 discusses "justifiable cause for failure to follow prescribed treatment" in more detail. It adds more reasons to the list set out in the above regulation, including the inability to afford treatment, which is what plaintiff is alleging in this appeal. The ruling explains:
S.S.R. 82-59, at 5. In
In the instant case, the ALJ considered plaintiff's failure to seek back surgery in October 2012 as a factor in his determination that plaintiff's impairment was not severe.
Turning back to the evidence cited by the ALJ, his discussion at page 18 of the Administrative Record clearly supports a conclusion that plaintiff chose not to have the recommended surgery because he was "uninterested," not due to financial concerns as no mention was made of that in the contemporaneous medical records referenced by the ALJ. The evidence just was not there for the ALJ to conclude that back surgery was a procedure plaintiff was "willing to accept" or for which "free community resources are unavailable." S.S.R. 82 59, at 5. The ALJ found that the plaintiff has had "little treatment overall." (Tr. 17).
The plaintiff asks the Court to find that there would have been more treatment if plaintiff had the opportunity to pay for it and that the ALJ penalized the plaintiff for not pursuing further treatment. The court cannot so find. Instead, the ALJ did not just rely on his conclusion of "little treatment overall," he reviewed the available record and supported his findings with substantial evidence. In the end, there simply is not evidence that would have supported a finding by the ALJ that plaintiff's lack of treatment was attributable to an inability to pay as plaintiff did not come forward with that evidence. Indeed, the evidence is antithetical to such a finding as plaintiff clearly testified "We've never signed up for any public assistance of any kind even though we could have last year, but we didn't." (T. 44). That is precisely the kind of evidence that slams the door on a § 416.930 analysis. While this Court's remand (discussed infra) is not based on this sub-assignment of error, it would nevertheless be appropriate for the ALJ to provide discuss the evidence as it relates to S.S.R. 82-59 and 20 C.F.R. § 416.930 in any subsequent decision.
Plaintiff asserts that the ALJ improperly "cherry-picked" evidence from "mixed results" of a Third Party Function Report completed by plaintiff's wife. (#8-1) at 24. Specifically, plaintiff alleges that the ALJ ignored evidence which contradicted the ALJ's RFC determination.
Social Security Ruling 96-8p explains that the RFC assessment "`must include a narrative discussion describing how the evidence supports each conclusion, citing specific medical facts (e.g., laboratory findings) and nonmedical evidence (e.g., daily activities, observations).'"
In his review of plaintiff's daily activities, the ALJ noted that plaintiff is able to watch television, `putter' in the garage, read the newspaper, use a computer, mow the lawn, water flowers, make photo albums, cook simple meals, run errands, wash dishes, socialize with friends, shop, manage money, and drive a car. (Tr. 14, 17). The ALJ cites these activities as reasons plaintiff's testimony lacked credibility, and why he afforded Dr. Brill's opinion great weight. (Tr. 17, 19). However, not discussed by the ALJ are portions of the Third Party Function Report (Tr. 193-202) which appear to conflict with the ALJ's finding. These portions received no analysis and no explanation as to the weight they were given in determination of plaintiff's RFC. These evidentiary conflicts are for the ALJ to resolve, not a reviewing court.
As mentioned, it is not for a reviewing court to resolve evidentiary conflicts.
Plaintiff asserts that the ALJ improperly used plaintiff's delay of three years between the alleged onset date of September 15, 2009 and the application filing date of November 27, 2012 against him. (8-1) at 23. Specifically, plaintiff alleges that the ALJ never asked plaintiff about this delay, and that the ALJ overlooked a disclosure by the representative of the District Office that it was he who recommended that plaintiff amend his claim to September 15, 2009 from is alleged onset date of March 15, 2011. (#8-1) at 23. Defendant argues that the use of this delay against plaintiff in the credibility determination was reasonable. Specifically, defendant argues that because plaintiff appeared to be doing well during this two-year period (i.e. plaintiff could ride a bike), it is likely that plaintiff did not get the "thought" to apply for disability until much later. (#12) at 20.
In his decision, the ALJ noted that this three year delay was "very long." (Tr. 16). The ALJ found that this "very long" delay between alleged onset of disability and filing date was "significant" in determining plaintiff's credibility. (Tr. 16-19). However, absent from the ALJ's decision is any discussion as to plaintiff's reasons for delay. Unlike the defendant in her brief, the ALJ does not speculate or make any findings as to plaintiff's state of mind during this time period. (Tr. 16). The ALJ did not ask the plaintiff about this delay in the hearing. The ALJ did not discuss the reasons why plaintiff amended their claim from March 15, 2011 to September 15, 2009. (Tr. 16). As argued by plaintiff in his brief, it is possible that plaintiff did not realize he was unable to return to gainful employment until after his unsuccessful work attempt in 2011. (#8-1) at 23. Instead of inquiring as to the reasons for the delay, the ALJ made a finding without explanation that this delay undermined plaintiff's credibility, leaving the court to guess as to why. The ALJ's finding that this delay is "significant" for the purposes of determining plaintiff's credibility is not based on substantial evidence.
The undersigned has carefully reviewed the decision of the ALJ, the transcript of proceedings, plaintiff's motion and brief, the Commissioner's responsive pleading, and plaintiff's assignment of error. Review of the entire record reveals that the decision of the ALJ not supported by substantial evidence, at least in part.