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Patrick Carnahan v. Michael J. Astrue

September 20, 2012

PATRICK CARNAHAN, CLAIMANT,
v.
MICHAEL J. ASTRUE, COMMISSIONER OF SOCIAL SECURITY, DEFENDANT.



The opinion of the court was delivered by: Baylson, J.

MEMORANDUM ON REQUEST FOR REVIEW

Claimant Patrick Carnahan seeks judicial review of a decision by the Commissioner of the Social Security Administration ("the Commissioner") denying his application for Supplemental Security Disability Insurance Benefits ("SSDI") and Supplemental Security Income ("SSI") under Titles II and XVI of the Social Security Act ("the Act"), 42 U.S.C. §§ 401-33, 1381-83(f). After careful consideration of all the relevant facts and circumstances, and for the reasons explained below, Carnahan's request for review of the July 2, 2010 decision of the Administrative Law Judge ("ALJ") is DENIED.

I. Background

A. Procedural History

On June 1, 2009, and June 18, 2009, Carnahan filed applications for SSDI and SSI, respectively. (Tr. 68, 284.) In both applications, he alleged disability beginning on October 30, 2008, due to valvular heart disease, hypertensive cardiovascular disease/hypertension, multiple joint arthritis, degenerative disc disease, asthma, right knee impairment, hip pain, severe back pain, major depression, and high cholesterol. (Id. 93, 288.) The Social Security Administration denied both applications on October 15, 2009. (Id. 28-32, 288-92.) Carnahan then requested a hearing before an ALJ. (Id. 33-35.) A hearing was held before ALJ Susan A. Flynn on June 23, 2010, in Philadelphia, Pennsylvania. (Id. 298.) At the hearing, Carnahan was represented by counsel and testified on his own behalf. (Id. 298-316.) A vocational expert ("VE") also testified. (Id. 316-21.)

On July 2, 2010, the ALJ denied Carnahan's applications for benefits. (Id. 18-25.) Carnahan subsequently sought review of the ALJ's decision before the Appeals Council. (Id. 13-14.) On October 25, 2011, the Appeals Council denied his appeal. (Id. 6-9.) The ALJ's decision thus stands as the final decision of the Commissioner. See Sims v. Apfel, 530 U.S. 103, 107 (2000).

On December 27, 2011, Carnahan commenced the instant action by filing a Complaint (ECF No. 1) requesting review of the ALJ's decision. On April 6, 2012, Carnahan filed a Brief and Statement of Issues in Support of Request for Review (ECF No. 6). On May 7, 2012, the Commissioner filed a Response (ECF No. 7) in opposition thereto. On May 17, 2012, Carnahan filed a Reply in further support of his request for review (ECF No. 8).

B. The ALJ Decision

In a written decision, the ALJ denied Carnahan's applications for benefits on the basis that he had the residual functional capacity (the "RFC") to perform past relevant work as a cashier/checker. (Tr. 25.) Initially, the ALJ found that Carnahan suffers from degenerative disc disease (DDD) of the lumbar spine and chronic obstructive pulmonary disease (COPD) -- medically determinable impairments that limit his ability to work and are, therefore, considered to be "severe" under the Social Security Regulations. (Id. at 20.) The ALJ also determined that Carnahan suffers from various additional impairments, including diabetes mellitus, osteoarthritis of the right knee, and status post myocardial infarcation. (Id.) However, according to the ALJ, these impairments are "non-severe" under the Social Security Regulations because they result in minimal, if any, limitation on his ability to work. (Id.)

After reviewing the evidence in the record, the ALJ determined that Carnahan "has the residual functional capacity to perform light work," subject to the following limitations:

[H]e can lift and carry 20 pounds occasionally and ten pounds frequently, he can stand or walk for six hours out of an eight hour workday and sit for six hours out of an eight hour workday. He can only occasionally climb stairs and ramps, and never climb ladders, ropes or scaffolds. He cannot crawl, and only occasionally balance, stoop, kneel, or crouch. He must avoid concentrated exposure to fumes, dust, odors, gases, and poor ventilation, and have only moderate exposure to temperature extremes. (Id. at 21-22.) In making this assessment, the ALJ found that Carnahan's medically determinable impairments could reasonably be expected to cause his alleged symptoms, which include, among other things, constant pain in his lower back, hip, knees, and ankles that lasts all day long and limits his ability to get up and move. (Id. at 23.) But the ALJ also found that Carnahan's statements concerning the intensity, persistence, and limiting effects of these symptoms were not credible to the extent they are inconsistent with above RFC assessment. (Id.) To be sure, the ALJ went so far as to conclude that Carnahan's "description of the severity of his alleged pain has been so extreme as to appear implausible." (Id.)

In reaching this conclusion, the ALJ considered Carnahan's daily activities, medical records, and the opinions of various physicians. With respect to Carnahan's daily activities, the ALJ determined that they were not limited to the extent one would expect in light of his subjective complaints. (Id.) Specifically, although Carnahan reported that he is in constant pain, he nevertheless testified that he is able to perform several activities of daily living, including household chores, shopping, walking to various locations to purchase necessities, preparing meals, dishwashing, and vacuuming. (Id.)

With respect to Carnahan's medical records concerning his DDD, the ALJ determined that they do not show degeneration of the lumbar spine to the extent expressed by Carnahan. In particular, the ALJ observed that a Magnetic Resonance Imaging ("MRI") of the lumbar spine taken on October 26, 2009 showed little to no disc herniation. (Id. at 23, 253.) In addition, an xray of the lumbar spine on the same date was unremarkable and normal. (Id. at 23, 255.) Moreover, an earlier MRI of the lumbar spine taken on June 4, 2009 showed only mild disc bulge with no herniation. (Id. at 23, 260.)

The ALJ also determined that Carnahan's medical records concerning his COPD only indicate a mild case of COPD. (Id. at 23.) Specifically, the ALJ observed that Ajay R. Pillai, M.D., a treating physician, reported on September 12, 2008, that Carnahan had stopped smoking and that he had clear lung sputum. (Id. at 23, 217.) Further, a pulmonary function test taken on July 30, 2009, indicated that, although Carnahan could not complete proper lung volume measurement, his forced vital capacity was normal, which would argue against any restrictive disorder, and he had only mild obstructive lung disease with reduced expiratory flow rates. (Id. at 23, 205.) Finally, Dr. Pillai diagnosed Carnahan with only mild COPD during a follow-up visit on September 11, 2009. (Id. at 23, 203.)

As for opinion evidence, the ALJ considered the following: (i) a handwritten note and a Multiple Impairment Questionnaire completed on July 8, 2008, and April 12, 2010, respectively, by Jon Fisher, D.O., a treating physician (id. at 135, 268-75); (ii) a Multiple Impairment Questionnaire completed on June 1, 2009, by Sanjay Gupta, M.D., a treating physician (id. at 186-93); (iii) a Physical Residual Functional Capacity Assessment completed on October 14, 2009, by Jerry Brenner, D.O., a state agency physician (id. at 230-36); and (iv) a Multiple Impairment Questionnaire completed on May 20, 2010, by Christian Fras, M.D., a treating physician (id. at 276-83).*fn1 Although the opinion of Dr. Brenner, the state agency physician, conflicted with those of Carnahan's treating physicians, the ALJ ultimately found that his opinion was entitled to more weight than theirs in assessing Carnahan's RFC. (Id. at 23-24.)

With respect to Dr. Fisher, the ALJ determined that his first medical source statement -- a handwritten note, dated July 8, 2008 -- was not entitled to any weight. (Id. at 23.) In that statement, Dr. Fisher concluded that Carnahan was disabled due to pain in the lumbar spine from degenerative joint disease, right knee pain, coronary artery disease, hypertension, dyslipidemia, asthma, COPD, shortness of breath, and being on multiple medications.*fn2 (Id.) The ALJ explained that the determination of whether a claimant is disabled is "an issue reserved for the Commissioner of Social Security to ascertain," and "[o]pinions by treating sources regarding the issue of disability are not entitled to controlling weight or special significance." (Id. at 23-24.) Therefore, the ALJ gave Dr. Fisher's opinion "no consideration because it draws a conclusion that is reserved for the Commissioner." (Id. at 24.)

The ALJ further determined that Dr. Fisher's Multiple Impairment Questionnaire, completed on April 12, 2010, deserved "little weight." (Id.) Dr. Fisher concluded that, on a scale of one to ten, Carnahan's pain level was at nine, and that he could only sit, stand, and walk at most one hour out of an eight-hour workday, occasionally lift and carry at most five pounds, and generally perform less than the full range of sedentary work. (Id.) According to the ALJ, this opinion was "not consistent with the medical record," which as discussed above, showed little deterioration of the lumbar spine and only mild COPD. (Id. at 24.)

For similar reasons, the ALJ also determined that Dr. Gupta's Multiple Impairment Questionnaire, completed on June 1, 2009, deserved "little weight." (Id.) In Dr. Gupta's view, Carnahan's MRIs indicated that he could only perform less than the full range of sedentary work because of his low back pain. (Id.) However, the ALJ found that Dr. Gupta's opinion was actually "inconsistent with [Carnahan's] MRIs which showed little degeneration in [his] lumbar region." (Id.) The ALJ also found it to be "inconsistent with the longitudinal evidence on record." (Id.)

Finally, the ALJ determined that Dr. Fras's Multiple Impairment Questionnaire, completed on May 20, 2010, deserved "little weight." (Id.) Dr. Fras concluded that, on a scale of one to ten, Carnahan's pain level was at eight, that he could only sit, stand, and walk for two hours out of an eight-hour workday, that he could only occasionally lift and carry five to ten pounds, that he had significant limitations in doing repetitive reaching, handling, fingering, or lifting, and that his symptoms would get worse if sent to work. (Id.) According to the ALJ, Dr. Fras's conclusion deserved little weight because it was "not consistent with the medical records," it was "based on [Carnahan's] own subjective reports," and it "only recommend[ed] physical therapy as a course of treatment for [his] back pain instead of a more aggressive course of treatment including medication, epidural injections, or surgical interventions." (Id.)

Unlike the foregoing opinions of Carnahan's treating physicians, the ALJ found that Dr. Brenner's Physical Residual Capacity Assessment completed on May 20, 2010, was entitled to "great weight." (Id.) In his assessment, Dr. Brenner concluded that Carnahan could perform light work with occasional postural limitations and no crawling. (Id.) The ALJ gave Dr. Brenner's opinion great weight because, in contrast to the opinions of Carnahan's treating physicians, it was "consistent with the medical evidence," and it was also "consistent with the records according to Dr. Brenner's narrative included within the assessment." (Id.) Accordingly, the ALJ determined that, along with "Carnahan's "exaggerated testimony" and his "diagnostic exams which show minor degeneration compared to [his] testimony," the RFC assessment was "supported by . . . the medical opinion of Dr. Brenner." (Id.)

Based on the foregoing, the ALJ concluded that Carnahan is capable of performing past relevant work as a cashier/checker. (Id. at 25.) The ALJ noted that Carnahan testified that he worked as a cashier/checker at Pathmark, where he stood for six hours, bagging groceries and working the register. (Id.) In that job, he had to lift very little, but he pushed and pulled the groceries. (Id.) The ALJ also noted that the VE testified that the job of cashier/checker, as Carnahan described it, and as described in the Dictionary of Occupational Titles (the "DOT"), is a "light, semi-skilled job," which was "performed at a light level due to [Carnahan's] testimony of standing." (Id.) The VE testified that Carnahan would be able to perform the requirements of this job, either under his own description of the job or the description of the job in the DOT. (Id.)

In comparing Carnahan's RFC with the physical and mental demands of his past relevant work as a cashier/checker, the ALJ concluded that he is able to perform this work as actually and generally performed. (Id.) Therefore, according to the ALJ, Carnahan is not under a disability, nor has he been since the alleged onset date. (Id.)

II. Legal Standards

A. Jurisdiction

The Social Security Act provides for judicial review by this Court of any "final decision of the Commissioner of Social Security" in a disability proceeding. 42 U.S.C. §§ 405(g), 1383(c)(3). A district court may enter a judgment "affirming, modifying, or reversing the decision of the Commissioner of Social Security, with or without remanding the cause for a rehearing." Id.

B. Standard of Review

On judicial review of the Commissioner's decision, the Commissioner's findings of fact, "if supported by substantial evidence," are conclusive. Id. Substantial evidence is "such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Smith v. Comm'r of Soc. Sec., 631 F.3d 632, 633 (3d Cir. 2010) (internal quotation marks omitted). It is a standard requiring "less than a ...


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