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Ellis v. Astrue

April 29, 2010

LINDA ELLIS, PLAINTIFF
v.
MICHAEL J. ASTRUE, COMMISSIONER OF THE SOCIAL SECURITY ADMINISTRATION, DEFENDANT



The opinion of the court was delivered by: Timothy R. Rice Magistrate Judge

REPORT AND RECOMMENDATION

Resolution of this case depends on whether the Administrative Law Judge ("ALJ") appropriately considered evidence of Linda Ellis' obesity in rejecting her application for Supplemental Security Income ("SSI"). Ellis claims the ALJ's decision is not supported by substantial evidence because the ALJ failed to adequately consider her obesity and its effect on her other impairments in determining her Residual Functional Capacity*fn1 ("RFC"). See Plaintiff's Brief and Statement of Issues in Support of Request for Review at 6-11, Ellis v. Astrue, 09-1212 (E.D. Pa. Dec. 21, 2009). This case requires interpretation of Diaz v. Comm'r of Soc. Sec., 577 F.3d 500, 503-05 (3d Cir. 2009), to determine when an ALJ must analyze obesity and its effect on other impairments.

After careful review, I find the ALJ was required to consider how Ellis' obesity, individually and in combination with other impairments, affected her ability to work. Therefore, the ALJ's decision was not supported by substantial evidence because the ALJ failed to properly consider and analyze Ellis' obesity. See Diaz, 577 F.3d at 503-05. Accordingly, I respectfully recommend Ellis' request for review be GRANTED and the matter be REMANDED to address Ellis' obesity and its impact on her other impairments and her ability to work.

BACKGROUND AND FACTUAL HISTORY

Ellis was 52 at the time of the ALJ's decision*fn2 and has a sixth grade education.*fn3 See R. 10; R. 24, 78. She has no relevant work history, R. 15, and lives with her daughter and grandchildren. R. 25, 73.

On April 20, 2006, Dr. Stephanie Flagg examined Ellis, who complained of ongoing bilateral knee pain when she climbed stairs and stood from a seated position. R. 100. Although there was no swelling in Ellis' knees and Ellis' February 2006 x-rays were normal, Dr. Flagg noted Ellis had pain in her bilateral patellofemoral grind*fn4 and diagnosed Ellis with patellofemoral degenerative joint disease.*fn5 R. 101. Dr. Flagg prescribed pain medication and, after considering Ellis' weight, recommended Ellis lose 20-25 pounds. Id.

On June 26, 2006, Ellis applied for SSI, alleging disability as of April 1, 2006 based on arthritis in the knees, hands, and wrist, diabetes, and high cholesterol. R. 65, 74. Obesity was not listed. See id. On September 11, 2006, after reviewing Ellis' application and medical records, Dr. Mark Bohn, a state agency consultant, concluded Ellis could do less than a full range of light work. R. 133-38. Dr. Bohn found the medical record supported Ellis' impairments of insulin dependent diabetes mellitus, hypertension, bilateral knee disorder, and obesity. R. 138. However, he concluded Ellis' alleged limitations were not supported by medical evidence because she had pursued follow-up care and had received conservative and routine treatment for her impairments. Id. Ellis' application was denied on September 13, 2006, R. 42-46, and she timely sought a hearing, R. 47-50.

Ellis and vocational expert Sherry Crystal Turetski testified on January 21, 2008. R. 21-40. Ellis testified her weight fluctuated between 268-298 pounds and her present weight was 268 pounds. R. 27. Ellis also testified: she had difficulty walking because of the arthritis in her knees; could usually walk about two blocks before she had to rest; could stand for about ten-to-fifteen minutes before experiencing pain in the back of her legs and in her back; and sometimes was bed-ridden due to pain. R. 29-30.

Ellis' claims were denied on February 28, 2008. R. 9-18. The ALJ applied the five-step sequential analysis*fn6 to determine Ellis' disability claim. R. 10-17. At step one, the ALJ found Ellis did not engage in substantial gainful activity at any time since the alleged onset of her disability. R. 10. At step two, the ALJ found Ellis suffered from the following severe impairments: insulin dependent diabetes mellitus, hypertension, bilateral knee disorders, and obesity. Id. At step three, the ALJ found Ellis' impairments or combination of impairments did not meet, or medically equal, one of the listed impairments.*fn7

The ALJ acknowledged that although obesity was deleted from the Listing of Impairments, he must assess Ellis' obesity at the other steps of the sequential evaluation process, such as determining Ellis' RFC, because the combined effect of obesity with other impairments can be greater than the effect of any single impairment. R. 11 (citing Social Security Ruling (SSR) 02-1p, 67 Fed. Reg. 57859, 57859 (Sept. 12, 2002)). This was the ALJ's only discussion of Ellis' obesity.

In determining whether Ellis' knee arthritis constituted a major joint dysfunction under Listing 1.02, the ALJ noted: (1) although Ellis complained of bilateral knee pain and had been diagnosed with patellofemoral degenerative joint disease, tests of her knees were within normal limits, see R. 12; and (2) Ellis' April 2006 physical examination showed she had good range of motion in both knees, no swelling, and pain only when "climbing stairs and getting up from her seat," see R. 12.

The ALJ then found Ellis had the RFC to perform light work, which requires maximum lifting of twenty pounds and frequent lifting of ten pounds, sitting for up to six hours, and standing and walking for up to six hours, in an eight-hour work day, with occasional bending, kneeling, crouching, crawling and climbing. R. 13. The ALJ did not fully credit Ellis' testimony and concluded the objective medical evidence failed to support the alleged severity of Ellis' impairments. R. 14. The ALJ stated there was no significant evidence of musculoskeletal compromise affecting Ellis' ability to stand, walk, or sit to the degree alleged. Id. The ALJ credited Dr. Bohn's state agency assessment*fn8 that Ellis could do less than a full range of light work, because Dr. Bohn "provided specific reasons for his opinion."*fn9 R. 14. The ALJ did not list or discuss Dr. Bohn's reasons. See R. 14. The ALJ did not mention or discuss Ellis' obesity in determining her RFC.

At step four, the ALJ found Ellis had no past relevant work, R. 15, and at step five, the ALJ determined there are a significant number of jobs in the national economy Ellis could perform based on her age, education, work experience, and RFC, R. ...


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