GLEN E. CONRAD, Chief District Judge.
Plaintiff has filed this action challenging the final decision of the Commissioner of Social Security denying plaintiff's claims for disability insurance benefits and supplemental security income benefits under the Social Security Act, as amended, 42 U.S.C. §§ 416(i) and 423, and 42 U.S.C. § 1381
The plaintiff, Joyce Sawyers, was born on August 16, 1958, and eventually completed her college education. Mrs. Sawyers received a bachelor's of business administration degree. (TR 43). Plaintiff has worked primarily as a customer service representative for a satellite television provider and as a newspaper delivery driver. She last worked on a regular and sustained basis in 2011. On June 27, 2011, Mrs. Sawyers filed an application for a period of disability and disability insurance benefits. Shortly thereafter, she also filed an application for supplemental security income benefits. In filing her applications, plaintiff alleged that she became disabled for all forms of substantial gainful employment on June 24, 2011, due to chronic diabetic neuropathy in her legs and feet; diverticulosis; depression; anxiety attacks; back deterioration and narrowing of the spinal canal; sleep apnea; diabetes; and classical migraines. Mrs. Sawyers now maintains that she has remained disabled to the present time. As to her application for disability insurance benefits, the record reveals that plaintiff met the insured status requirements of the Act at all relevant times covered by the final decision of the Commissioner.
Mrs. Sawyers' applications were denied upon initial consideration and reconsideration. She then requested and received a
(TR 30). Given such a residual functional capacity, and after considering plaintiff's age, education, and work experience, as well as testimony from a vocational expert, the Law Judge ruled that Mrs. Sawyers retains the capacity to return to her past relevant work as a customer service representative. (TR 31). Accordingly, the Law Judge ultimately concluded that Mrs. Sawyers is not disabled, and that she is not entitled to benefits under either federal program.
After a review of the record in this case, the court is constrained to conclude that the Commissioner's final decision is supported by substantial evidence. Mrs. Sawyers suffers from a variety of musculo skeletal problems, complicated by peripheral diabetic neuropathy. Objective studies have revealed fairly severe spinal stenosis in her lumbar spine, as well as degenerative changes in her cervical spine, lumbar spine, left shoulder, and knees. She also experiences morbid obesity. For the most part, Mrs. Sawyers has received conservative treatment for her physical discomfort. She has been seen on a regular basis at The Pain Center of Christiansburg. Based on the reports from the Pain Center, it is clear that plaintiff is disabled for anything other than a limited range of sedentary work activity. Indeed, three nurse practitioners who have evaluated Mrs. Sawyers have produced reports indicating that she is disabled for all forms of work.
The difficulty in this case is that there are no "acceptable medical sources," within the meaning of 20 C.F.R. §§ 404.1513(a) and 416.913(a), who have submitted evidence documenting total disability. Based on his examinations at the Pain Center, Dr. Don Bivins, a treating neurologist, has submitted several functional assessments. (TR 570-71, 572-73). While plaintiff suggests that Dr. Bivins' assessment forms are incomplete, it is clear that Dr. Bivins responded to certain of the questions on the forms, and that he did not suggest that Mrs. Sawyers is totally disabled. An orthopaedic specialist, Dr. Jeffery R. Chain, assessed plaintiff's knee problems on referral from the Pain Center. Dr. Chain listed physical findings as follows:
(TR 689). Dr. Chain diagnosed mild degenerative arthritis in both knees.
Dr. Raymond V. Harron, a neurosurgeon evaluated Mrs. Sawyers on November 26, 2012, also on referral from the Pain Center. Dr. Harron summarized plaintiff's complaints as follows:
(TR 699). The neurosurgeon submitted the following clinical findings and impressions:
I did discuss with her laminectomy and foraminotomy at L3/L4 and L4/L5. I did review the surgical procedure itself, its risks, complications, and limitations with her. She asked about laser spine surgery. I told her that procedure is not done in this area, but I did refer her to some interne web site she can go to for further information regarding this problem. She is not sure how she would like to proceed at this time and would like to have some time to think about her options.
(TR 699-700).
Finally, the court notes that the Law Judge relied on functional assessments completed by two, nonexamining state agency physicians. In a report dated August 19, 2011, Dr. Robert Keeley submitted findings which indicate that plaintiff could be expected to work for a total of eight hours each day, if she is allowed to occasionally change positions. (TR 70-72). Another state agency physician, Dr. Richard Surrusco, offered similar impressions in a report completed on February 25, 2002. (TR 92-95).
The court believes that the Law Judge reasonably relied on the reports from Dr. Bivins, Dr. Chain, Dr. Harron, Dr. Keeley, and Dr. Surrusco in concluding that Mrs. Sawyers is not disabled for past relevant work. After assessing plaintiff's residual functional capacity, the Law Judge also received input from a vocational expert who specifically concluded that Mrs. Sawyers could return to the customer service representative position. (TR 60). It appears to the court that the vocational expert's evaluation of the vocational factors, and the assumptions under which the expert deliberated, are fully consistent with the evidence in this case. In short, while the medical reports are in conflict, the court believes that there is substantial evidence to support the Law Judge's determination that plaintiff retains the residual functional capacity to perform past relevant work. It follows that the Commissioner's final decision must be affirmed.
On appeal to this court, Mrs. Sawyers maintains that the Administrative Law Judge failed to give adequate weight to the reports of three nurse practitioners, all of whom produced functional assessments which support a finding of total disability.' Mrs. Sawyers notes that she has been seen by the nurse practitioners on a much more regular basis than by any of the medical doctors in this case. Finally, Mrs. Sawyers points out that, under Social Security Ruling 06-03p, it is necessary for the Commissioner to consider evidence from medical personnel, such as nurse practitioners, who do not qualify as acceptable medical sources under the regulations, 20 C.F.R. §§ 404.1513(a) and 416.913(a).
While the court believes that it is somewhat bothersome that the Law Judge stated that she gave "no weight to the opinions of the nurse practitioners," (TR 31), the court must conclude that the Law Judge reasonably gave greater weight to the findings from the acceptable medical sources. All of the nurse practitioners worked under the supervision of Dr. Bivins. Yet, it is undisputed that Dr. Bivins did not state that Mrs. Sawyers experiences a disabling level of subjective discomfort. Moreover, Dr. Harron and Dr. Chain both saw plaintiff on referral from the Pain Center. The court agrees that a fair reading of the reports from these two specialists supports the finding that plaintiff is not disabled for sedentary levels of work activity. Finally, in what is otherwise a close case, the court believes that the Law Judge reasonably relied on input
As correctly noted by the plaintiff, the Law Judge actually took note of reports from only two of the nurse practitioners, Carol Ballard and Faye Lyons. A third nurse practitioner, Douglas Larner, also assessed plaintiff's functional capabilities. (TR 565). While Mr. Larner's report also appears to be incomplete, he suggested that Mrs. Sawyers "must alternate frequently" between sitting, standing, and walking. The court agrees that Mr. Larner's report suggests that plaintiff is not able to perform work on a sustained basis. from the state agency physicians, especially since those doctors are trained in matters of disability assessment. Accordingly, the court concludes that the Law Judge did not err in declining to fully credit the reports and opinions from the nurse practitioners.
On appeal, Mrs. Sawyers also contends that the Law Judge improperly discounted testimony given by plaintiff at the administrative hearing on May 30, 2013. Without question, Mrs. Sawyers' testimony indicates that she is no longer able to do even the sedentary work activity she previously performed as a customer service representative. However, in terms of plaintiff's subjective complaints, it must be noted that, in order for pain to be deemed disabling, there must be objective medical evidence establishing the existence of some condition that could reasonably be expected to produce the pain alleged.
In affirming the final decision of the Commissioner, the court does not suggest that plaintiff is free of all pain in her back and legs. It is essentially undisputed that Mrs. Sawyers has experienced degenerative changes and circulatory problems which prevent performance of lighter forms of work activity. However, the fact remains that no acceptable medical source has identified any mechanical problems or circulatory impairment which could be expected to prevent performance of sedentary work activity. Indeed, all of the doctors in this case have suggested that plaintiff's pain complaints can be addressed through conservative, noninvasive medical treatment. It is well settled that the inability to do work without any discomfort, does not of itself render a claimant totally disabled.
As a general rule, resolution of conflicts in the evidence is a matter within the province of the Commissioner even if the court might resolve the conflicts differently.
The Clerk is directed to send certified copies of this opinion to all counsel of record.