SARAH NETBURN, Magistrate Judge.
Diana G. Garcia seeks judicial review of the Commissioner of Social Security's determination finding her disabled only from May 12, 2012, to June 1, 2013, but denying her disability insurance benefits ("DIB") for any time before or after that date. 42 U.S.C. § 405(g). Garcia claims that her disability—resulting in pain in her lower back pain, right knee, and left hand—persisted after June 1, 2013. An Administrative Law Judge ("ALJ") determined that the medical evidence did not support Garcia's account of her symptoms' persistence and credited the opinion of a consultative examiner who testified that Garcia was capable of working within the full range of sedentary work after June 1, 2013.
Garcia and the Commissioner cross-move for judgment on the pleadings under Federal Rule of Civil Procedure 12(c). I conclude that the ALJ's disability determination was supported by substantial evidence and free from legal error. Accordingly, Garcia's motion for judgment on the pleadings is DENIED, and the Commissioner's cross-motion is GRANTED.
Garcia applied for DIB on October 13, 2012, alleging disability since April 17, 2010, as a result of back pain, resulting in surgery, and lumbar radiculopathy
Garcia testified that her last job was as a dispatcher associate for Cable Vision. She performed data entry and assisted technicians remotely in installing cable boxes in customers' homes. She worked at Cable Vision for 11 years until she was terminated in April 2010 because of her disability. As a dispatcher associate, she sat without any need for lifting. Garcia received unemployment benefits for two years after being terminated from Cable Vision. In order to receive unemployment benefits, she was required to certify that she was ready, able, and willing to work. Garcia admitted that, during those two years, she would have been able to work if she needed to support herself.
Garcia reported "complications with sitting" and "sharp pains" in her back after undergoing back surgery in December 2012. Administrative Record ("AR") at 54, 74. Because of her back pain, Garcia could not sit for more than 15 minutes at a time.
In terms of activities of daily living, Garcia read the Bible, occasionally watched television, and socialized with her family. She relied on her family and boyfriend to buy groceries, prepare meals, and clean. She was unable to lift a gallon of milk.
On September 10, 2012, Garcia reported pain in both feet to podiatrist Dr. Hernandez, who diagnosed her with bursitis
Garcia denied any stiffness, pain or swelling in her left foot at a November 5, 2012 visit with Dr. Hernandez, who diagnosed her with athlete's foot.
Garcia did not see Dr. Hernandez again until March 4, 2013, when she presented with bilateral foot pain while walking. Dr. Hernandez assessed bursitis and plantar flexion deformity. She returned to Dr. Hernandez on June 3, 2013, with complaints of left foot pain. Dr. Hernandez did not find any instability of the left foot but discussed surgical management and antiinflammatory medication and encouraged her to modify her shoes.
Garcia again presented with foot pain at an October 2013 appointment. She had orthotics but did not use them. Dr. Hernandez instructed her to wear the orthotics and to modify her shoes. She visited Dr. Hernandez on November 4, 2013, with complaints of fungal toenails but no pain.
In January 2014, Garcia informed Dr. Hernandez that her foot pain was "getting better." AR at 673-75.
Garcia visited Dr. Guy on September 20, 2012, with reports of lower back pain radiating down her left leg. Garcia had tried physical therapy without improvement. Based on a physical examination, Dr. Guy concluded Garcia had diffuse tenderness and spasm but an active range of motion and a normal gait. Dr. Guy referred Garcia to Dr. Joshua Auerbach for a surgical consultation.
In a follow-up appointment on October 25, 2012, Garcia presented to Dr. Gray with continued pain in her lower back, right knee, and both hands. Dr. Guy noted that Dr. Auerbach had recommended surgery after examining Garcia. On examination, Dr. Guy observed that Garcia's right knee was swollen with a popliteal cyst and that both of her thumbs had osteoarthritic deformities. Garcia's gait was normal. Dr. Guy referred her to Dr. Gabriel Dassa for an evaluation of her right hand and knee pain.
Dr. Auerbach examined Garcia on October 8, 2012. A physical examination revealed a normal gait and a positive straight leg raise on the left. Dr. Auerbach found Garcia to be neurologically intact. He diagnosed Garcia with foraminal disc herniation with anterolisthesis
On December 5, 2012, Garcia underwent posterior lumbar L4-S1 fusion surgery performed by Dr. Auerbach. Upon her discharge on December 19, 2012, Garcia was instructed to walk as much as she felt able to; limit stair climbing to only a few times per day; not bend from the waist; limit lifting to less than 10 pounds with no twisting when lifting and carrying; and limit sitting to 20 or 30 minutes at a time.
After the surgery, Dr. Auerbach consistently described Garcia's condition as improving. At a December 28, 2012 follow-up appointment, he observed that Garcia "ha[d] done beautifully" with "no complications." AR at 295. Garcia had "no leg pain and only mild back pain." She was "at home walking upright with no leg pain and mild back pain doing very wonderfully and is very happy with her progress today."
In February 2013, Garcia was doing "beautifully from the clinical standpoint," with "no leg pain."
Garcia visited Dr. Auerbach on May 2, 2013 for another re-evaluation. Garcia was again "doing beautifully" with "mild low back pain" and "no pain going down the legs."
At an August 2, 2013 visit, Garcia's post-surgery outcome remained "excellent," her lower back pain had significantly improved from her pre-surgery condition, and she experienced no leg pain.
Dr. Dassa reviewed x-rays of Garcia's right foot, left shoulder, and left hand that were taken in November 2012 and March 2013. The November 2012 x-ray of the right foot showed changes of the first and second metatarsal bones and a flattened plantar arch. The March 2013 x-rays of her left shoulder and left hand were unremarkable.
At a September 2013 visit with Dr. Dassa, Garcia presented with pain in her right knee. She had received a cortisone injection during a previous visit that "alleviated two thirds of her pain" and requested a new injection.
Garcia visited Dr. Dassa on November 5, 2013, for a follow-up on a previously administered injection into the carpal metacarpal of her left hand. According to Garcia, the injections "relieved a lot of her pain," and she was overall "very pleased [with] operative treatment."
At a January 15, 2014 appointment, Garcia presented with increased pain from standing. Dr. Dassa observed that both of Garcia's knees had a full, active range of motion. Garcia requested cortisone injections, indicating that physical therapy was of little help.
Garcia visited Dr. Maclennan on November 8, 2012, for a physical examination, which revealed unremarkable findings. Dr. Maclennan observed that Garcia was able to maintain "good balance." AR at 635.
At an appointment on April 17, 2013, Garcia complained of back pain to Dr. Maclennan, who observed abnormalities in Garcia's gait, spine stiffness, tenderness, and scoliosis. Dr. Maclennan encouraged Garcia to continue taking Percocet and Cymbalta.
At a visit with Nurse Practitioner Caroline Luke on May 23, 2013, Garcia complained that her back pain was "coming back with pinching sensations." AR at 631. She also reported "pain with sitting too long" and "pain with walking."
At a visit with Nurse Luke on June 10, 2013, Garcia's only concerns were hand pain and a desire to lose weight. Garcia's left hand showed swelling and tenderness. Nurse Luke diagnosed Garcia with neuropathy of her left hand and referred her to a hand surgeon.
Garcia visited Dr. Schwechter on June 17, 2014, for an evaluation of right knee pain complaints. Upon examination, Dr. Schwechter observed that her knees were stable and neurovascularly intact. In addition, Garcia's hips had a normal range of motion.
Dr. Corvalan performed a consultative examination on February 11, 2013, in connection with Garcia's DIB claim. Garcia mentioned her December 2012 back surgery and reported "constant" pain in her lower back that was aggravated by sitting, standing, walking, bending, climbing stairs, and lifting and carrying heavy objects. AR at 551. Regarding activities of daily living, Garcia was able to cook twice a week; bathe and dress herself; and clean, do laundry, and shop with help. She spent most of her time watching television, listening to the radio, reading, going to doctor appointments, and shopping for food. During the examination, Garcia ambulated with a walker and rose from the chair with some difficulty but did not need any help changing for the examination. Her hand and finger dexterity were intact. There was some tenderness on palpation of the lumbar spine area.
Dr. Corvalan diagnosed Garcia with low back pain. He opined that she had "moderate limitation[s]" for sitting or standing for long periods of time, walking long distances, bending, squatting, climbing stairs, lifting, and carrying heavy objects.
Orthopedic surgeon Dr. Brahms attended the February 21, 2014 supplemental hearing after reviewing Garcia's medical records. He testified that six months after Garcia's December 2012 surgery, she had "no restrictions against sedentary work." AR at 83. Any functional restrictions were only "standing a long time and lifting heavy objects" as a result of her back problems.
On July 31, 2014, in response to interrogatories sent by the All, Dr. Brahms affirmed that Garcia was disabled for the closed period from May 12, 2012, to June 1, 2013, but that she was able to perform sedentary activity after June 1, 2013. He noted that after the surgery in December 2012 (which had provided some benefit), the back pain, though less severe, persisted. In reviewing a February 2014 CT scan, Dr. Brahms found that the internal fixation was intact but that there was "slight spondylothesis
In a Medical Source Statement of Ability to do Work-Related Activities, dated July 31, 2014, Dr. Brahms indicated that Garcia could occasionally lift and carry up to ten pounds; that she could sit for up to two hours, stand for 30 minutes, and walk for 30 minutes at one time without interruption; and that she could sit for six hours, stand for two hours, and walk for one hour at one time without interruption. Garcia could also perform activities like shopping; travel without a companion for assistance; walk without using a wheelchair, walker, canes or crutches; use public transportation; prepare a simple meal and feed herself; and care for her personal hygiene.
At the February 21, 2014 supplemental hearing, vocational expert Raymond E. Cestar first testified that Garcia's previous job as a dispatcher was sedentary. When asked whether a hypothetical claimant capable of performing the full range of sedentary work could perform Garcia's past job as a dispatcher, Mr. Cestar responded in the affirmative. Mr. Cestar also noted that the hypothetical claimant could work as a trouble locator or desktop helper. The hypothetical claimant, according to Mr. Cestar, could not work as either a dispatcher or trouble locator if he or she took a 10-15 minute break every 15 minutes or was off task for 20 percent of the time.
The ALJ found that, as of May 2012, Garcia had the following severe impairments: degenerative spondylolisthesis in her lower spine that required surgery in December 2012; a meniscus tear in her right knee; bursitis of her feet; and neuropathy in her left hand. Based on the opinion of Dr. Brahms, the ALJ determined that Garcia's back impairment met the listing from May 12, 2012, to June 1, 2013, but not before or after that period. In addition, the All declined to find that pain in Garcia's right knee was disabling, asserting that the "clinical signs" with regards to the knee were "few" and that her "pain continued to be well managed with treatment." AR at 35-36.
As of June 1, 2013, according to the ALJ, Garcia had the residual functional capacity ("RFC") to perform the full range of sedentary work, based on Dr. Brahms's interrogatory responses that Garcia was able to perform sedentary exertion as of that date. The ALJ went on to find that as of June 1, 2013, Garcia was capable of performing her past work as a dispatcher, which did not require performing the specific work-related activities precluded by her RFC (such as lifting or carrying extremely heavy weights). The All concluded that Garcia was disabled from May 12, 2012, to June 1, 2013, but not before or after that period.
Garcia seeks review of the Commissioner's decision under 42 U.S.C. § 405(g) and moves for judgment on the pleadings under Federal Rule of Civil Procedure 12(c). She contends that the ALJ improperly afforded limited weight to her treating physicians and her own testimony regarding her conditions and symptoms, and overestimated her ability to sustain full-time employment for a sedentary job. The Commissioner cross-moves for judgment on the pleadings, arguing that the ALJ's decision was supported by substantial evidence and free from legal error.
A motion for judgment on the pleadings should be granted if it is clear from the pleadings that "the moving party is entitled to judgment as a matter of law."
Thus, "in order to accommodate `limited and meaningful' review by a district court, the ALJ must clearly state the legal rules he applies and the weight he accords the evidence considered."
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 12 months." 42 U.S.C. §§ 423(d)(1)(A), 1382c(a)(3)(A). A determinable physical or mental impairment is defined as one that "results from anatomical, physiological, or psychological abnormalities which are demonstrable by medically acceptable clinical and laboratory diagnostic techniques." 42 U.S.C. § 1382c(a)(2)(D). A claimant is determined to be disabled only if the impairments are "of such severity that he is not only unable to do his previous work but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy . . . ." 42 U.S.C. § 1382c(a)(2)(B).
The Social Security Administration has established a five-step sequential evaluation process for making disability determinations.
The ALJ determined that Garcia had the RFC to perform the full range of sedentary work as of June 1, 2013, based on the opinions of Dr. Brahms, Dr. Auerbach, and Dr. Dassa. Garcia asserts that her spinal impairments and right knee impairment currently meet the criteria for Sections 1.04 and 1.02(A) of the Listings, respectively, and that, as a result of these impairments, she remains disabled and unable to work. She further contends that, had the ALJ correctly weighed the opinions of her treating physicians regarding the impairments in her spine and knee, his assessment of Garcia's RFC would have been different, and he would not have concluded that she was disabled for only a one-year period.
The Social Security regulations require the ALJ to give controlling weight to the opinions of "treating sources" when those opinions are well-supported by medical evidence and "not inconsistent with the other substantial evidence." 20 C.F.R. § 416.927(c)(2). Treating sources "are likely to be the medical professionals most able to provide a detailed, longitudinal picture" of impairments and may "bring a unique perspective to the medical evidence that cannot be obtained from the objective medical findings alone or from reports of individual examinations, such as consultative examinations . . . ."
The ALJ's finding that Garcia was disabled because of spinal impairments for only a closed period ending on June 1, 2013, is supported by substantial evidence. Her treating surgeon, Dr. Auerbach, consistently reiterated that her back pain was no longer of Listing-level severity as of June 2013. At a follow-up appointment on December 28, 2012, Dr. Auerbach stated that she "ha[d] done beautifully" with "no complications" and "only mild back pain." AR at 295. Garcia was "at home walking upright" and was "very happy with her progress today."
Upon re-examination in August 2013, Dr. Auerbach found Garcia "really had an excellent outcome" from her surgery and had "done beautifully," with significant improvement in her back pain compared to her pre-surgery condition.
Based on Dr. Auerbach's records, Dr. Brahms concluded that Garcia was disabled because of spinal impairments for only a circumscribed period ending on June 1, 2013. There is no evidence of any impairment and no evidence of treatment or medical opinion referring to a condition before May 2012. With regards to the period after June 2013, Dr. Brahms determined that Garcia had less severe back pain, intact internal fixation, and only slight spondylothesis. According to Dr. Brahms, Garcia was able occasionally to lift and carry up to ten pounds, sit for six hours, stand for two hours, and walk for one hour. Although Dr. Brahms restricted Garcia from climbing ladders or scaffolds, stooping, kneeling, and working near unprotected heights, moving mechanical parts, and vibrations, nothing in Dr. Brahms's conclusion indicated that she could not perform sedentary work. In fact, his finding that she could sit for six hours and stand for two hours reinforces that Garcia was fully capable of performing sedentary work.
Garcia contends that the ALJ erred in not finding that her right knee impairment satisfied the Listing criteria. Listing 1.02 requires a major dysfunction of a joint, specifically "gross anatomical deformity" and "chronic joint pain and stiffness" with "signs of limitation of motion or other abnormal motion of the affected joint(s)." 20 C.F.R., Part 404, Subpart P, Appendix 1, Listing 1.02A. Subpart A of Listing 1.02 further requires an "inability to ambulate effectively."
Garcia has not demonstrated a "gross anatomical deformity" of her right knee. Diagnostic testing in July 2014 revealed a complex tear of the medial meniscus, moderate joint effusion, and mild osteoarthritis. None of these conditions qualifies as a gross anatomical deformity. Indeed, Dr. Brahms described the "early degenerative arthritic changes" in her knee as of "minimal consequence."
Furthermore, Garcia herself reported on at least two occasions that her knee pain was well-managed by injections. Garcia received an injection from Dr. Dassa in August 2013 in response to swelling and pain in her right knee. At a September 2013 appointment, she reported that the previous month's injection had reduced her pain by "two thirds" and requested a new injection.
Garcia argues that the All improperly rejected her own account of her physical impairments. It is the ALJ's role to evaluate a claimant's credibility and to decide whether to discredit a claimant's subjective estimate of the degree of her impairment.
Garcia testified that her physical impairments have caused and continue to cause a significant degree of interference with activities of daily living. She could not lift a gallon of milk. She used a walker and a cane and would continue to do so unless advised by her doctor to do otherwise. She wore a brace at all times and could not bend or retrieve an object she dropped. In addition, Garcia could not dress or otherwise groom herself. She needed help with cleaning and could not walk, sit or lie down for a period of time. Despite Garcia's allegations, the ALJ concluded that Garcia's account of the severity and persistence of her physical impairments was not credible.
The ALJ's credibility determination was supported by substantial evidence. Garcia's testimony of her impairments is inconsistent with her treating physicians' medical records and her own statements to the treating sources that her conditions were improving. Moreover, her reports of pain often included concessions that the pain was aggravated by actions outside of the ALJ's RFC (such as excessive walking) or corrective measures that she failed to heed (such as not wearing orthotics or shoe modifications).
First, Garcia mentioned she had "a lot of pain" in her back that started in December 2012.
In addition, at the February 14, 2014 hearing, Garcia testified she had knee pain and swelling. But, in August and September 2013, Garcia reported significant relief in her knee pain as a result of periodic injections. Orthopedic testing performed by Dr. Dassa in November 2012 and March 2013 (during the ALJ's period of disability) showed a normal range of motion in her knees. In September 2013, Garcia told Dr. Dassa that injections had alleviated two thirds of her pain. Two months later, she reiterated that the injections were helping and rated her pain as only 3/10. Garcia admitted that excessive walking exacerbated her knee pain, which the ALJ's RFC of post-June 1, 2013 sedentary exertion accordingly takes into account. During an appointment with Dr. Schwechter in June 2014 for pain in her right knee, Garcia maintained that she could walk for less than two blocks at a time and found physical therapy to be unhelpful. But Dr. Schwechter's examination was unremarkable, revealing both knees to be stable and range of motion to be normal.
Besides back and knee pain, Garcia's foot pain appears to have been resolved after the circumscribed period of disability. In September 2012, Garcia complained that she had been experiencing pain in her left foot for the past six months. An examination showed 5/5 strength, no instability, and intact sensation but some tenderness in the plantar metatarsal heads. Garcia was diagnosed with bursitis and tendinitis, and received an injection. During a follow-up appointment in October 2012, she was given another injection, a night splint, and a shoe modification. But a month later, she displayed no instability or diminished nerve sensation; instead, a physical examination showed a full range of motion and stability. In addition, Garcia reported in November 2012 that her foot pain was occasional and only aggravated by walking (which sedentary exertion should not affect). At the time, she denied having any stiffness, pain or swelling in her left foot at a follow-up examination with Dr. Hernandez. Garcia sought treatment for foot pain sporadically throughout 2013. In April 2013, she was again diagnosed with bursitis and received another injection. Garcia reported feeling some exacerbation of pain in her foot in October 2013 but also admitted that she had not been using orthotics or shoe modifications. As of January 2014, Garcia informed Dr. Hernandez that her foot pain was getting better.
Finally, Garcia testified that she had carpal tunnel and numbness in her hands. The pain in Garcia's left hand, however, appears to have been fully treated after June 2013 as well. X-rays of the left hand and shoulder taken in March 2013 were unremarkable. After Garcia was diagnosed with neuropathy of the left hand in June 2013, she received steroid injections. At a follow-up appointment in November 2013, she reported that the previous injections relieved a lot of her pain. Her treating provider assessed minimal inflammation of her left hand and a full range of motion.
Accordingly, the ALJ's credibility determination rests on substantial evidence. In addition, his assessment reflects due consideration of the inconsistencies between Garcia's subjective complaints of pain and the findings and opinions of the treating and consultative sources. Therefore, there is no basis to set it aside.
Garcia contends that she cannot return to her past work as a dispatcher because the responsibilities of a dispatcher are inconsistent with the "numerous restrictions" imposed by her treating doctors, as well as by the ALJ's RFC determination. This argument is not persuasive.
Garcia acknowledged that her past employment as a dispatcher was sedentary in nature. She was never required to lift anything.
The ALJ's Step Five analysis was supported by substantial evidence and consistent with Garcia's own description of her past job. The ALJ reviewed evidence and heard testimony that Garcia was capable of sedentary exertion and that any restrictions such as lifting or standing for long periods would be accommodated. The Court is limited to determining whether a reasonable person could conclude, based on the evidence, whether Garcia retained the capacity to perform her past work as a dispatcher, which involved primarily sitting at a desk for periods of time. The ALJ based his conclusion that she could do so on substantial evidence in the record, and there is no basis for overturning it.
For the reasons stated above, Garcia's motion for judgment on the pleadings is DENIED, and the Commissioner's cross-motion for judgment on the pleadings is GRANTED.
The Clerk of Court is respectfully directed to terminate the motions at ECF Nos. 14 and 16.
