United States District Court, M.D. Pennsylvania
REPORT AND RECOMMENDATION
SUSAN E. SCHWAB, Magistrate Judge.
I. INTRODUCTION AND PROCEDURAL HISTORY.
The Plaintiff, James Ainsworth, Jr. ("Ainsworth"), appeals the February 23, 2012, adverse decision denying his application for disability insurance benefits ("DIB") under Title II of the Social Security Act ("Act") and supplemental security income benefits ("SSI") under Title XVI of the Act. 42 U.S.C. §§ 401-433, 1381-1382f; Doc . 1. Ainsworth contends that the final decision of the Commissioner, denying his applications for benefits, is unsupported by substantial evidence. He raises three issues in support of his contentions. First, he argues that the Administrative Law Judge's ("ALJ") decision is rendered defective by a flawed evaluation of the medical evidence of record. Second, he argues that the ALJ erred in relying on the testimony of an impartial vocational expert ("VE") as substantial evidence in support of his decision. Third, Ainsworth asserts that the ALJ's decision is rendered defective by a flawed evaluation of the credibility of Ainsworth's subjective testimony, which he alleges is fully supported by evidence from his fiancee.
On July 18, 2013, the Commissioner filed an Answer to Ainsworth's Complaint and a copy of the administrative record. Thereafter, both parties filed separate briefs in support of their respective positions. Jurisdiction over this case is conferred upon this Court pursuant to 42 U.S.C. § 405(g) and 42 U.S.C. § 1383(c)(3). On October 10, 2013, this matter was referred to the undersigned Magistrate Judge for pretrial management and the preparation of a report and recommended disposition. This appeal has been fully briefed and is now ripe for resolution.
Upon consideration of the entire record submitted by the parties, and for the reasons set forth below, I recommend that the Commissioner's final decision be affirmed.
II. SUMMARY OF THE ADMINISTRATIVE PROCEEDINGS.
Ainsworth was born on December 11, 1968, Doc . 13, p. 2, and was 41 years old on his alleged onset date of disability. Tr . 15, 34. Under the Social Security Regulations ("Regulations") he is considered a "younger person;" therefore, his age presents little or no barrier to his adjustment to alternative employment. 20 C.F.R. §§ 404.1563(c), 416.963(c). He has a high school education and is able to communicate in English. Tr . 34. Ainsworth applied for DIB and SSI on April 26, 2010, alleging that he had been disabled since May 1, 2009, in large part due to pain in his right knee. The Administration denied Ainsworth's claim initially on October 7, 2010. Ainsworth timely filed a request for a hearing on November 14, 2010, which was granted. Thereafter, Ainsworth, on November 17, 2011, represented by counsel, appeared and testified during an administrative proceeding before ALJ Peter V. Train in Harrisburg, Pennsylvania. VE Paul A. Anderson also appeared and testified during the administrative proceeding. Thereafter, the ALJ denied Ainsworth's applications for benefits in a written decision on February 23, 2012.
Following the ALJ's denial of his claims, Ainsworth sought review of the ALJ's decision by the Appeals Council of the Office of Adjudication and Review ("Appeals Council"). On April 29, 2013, the Appeals Council denied Ainsworth's request. Therefore, the ALJ's decision, dated February 23, 2012, denying Ainsworth's claims, is the "final decision" of the Commissioner subject to judicial review by this Court under the Act. 20 C.F.R. §§ 404.981, 416.1481.
To receive benefits under Title II or XVI of the Act, a claimant must demonstrate an "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); see also 20 C.F.R. §§ 404.1505(a), 416.905(a). Furthermore:
[a]n individual shall be determined to be under a disability only if his physical or mental impairment or 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, regardless of whether such work exists in the immediate area in which he lives, or whether a specific job vacancy exists for him, or whether he would be hired if he applied for work. For purposes of the preceding sentence (with respect to any individual), "work which exists in the national economy" means work which exists in significant numbers either in the region where such individual lives or in several regions of the country.
42 U.S.C. §§ 423(d)(2)(A), 1383c(a)(3)(B). In addition to the above-listed requirements, to receive benefits under Title II of the Act, a claimant must show that he or she contributed to the insurance program, is under retirement age, and became disabled prior to the date on which he or she was last insured. 42 U.S.C. § 423(a); 20 C.F.R. § 404.131(a). Title XVI, however, is a needs-based program; thus, eligibility under Title XVI is not contingent upon a claimant's insured status.
It is the responsibility of the ALJ to determine whether a claimant has met the statutory prerequisites for entitlement to benefits. In making this determination the ALJ employs a five-step evaluation process to determine if a person is eligible for disability benefits. See 20 C.F.R. §§ 404.1520, 416.920; see also Plummer v. Apfel , 186 F.3d 422, 428 (3d Cir. 1999). As part of this analysis the ALJ must sequentially determine: (1) whether the claimant is engaged in substantial gainful activity; (2) whether the claimant has a severe impairment; (3) whether the claimant's impairment meets or equals a listed impairment; (4) whether the claimant's impairment prevents the claimant from doing past relevant work; and (5) whether the claimant's impairment prevents the claimant from doing any other work. See 20 C.F.R. §§ 404.1520, 416.920. If the ALJ finds that a claimant is disabled or not disabled at any point in the sequence, review does not proceed any further. See 20 C.F.R. §§ 404.1520(a)(4), 416.920(a)(4). Moreover, between steps three and four of this process, the ALJ must determine the claimant's residual functional capacity ("RFC") as defined by 20 C.F.R. §§ 404.1545, 416.945. 20 C.F.R. §§ 404.1520(e), 416.920(e).
The claimant bears the initial burden of demonstrating that he or she has a medically determinable impairment that prevents him or her from engaging in past relevant work. 42 U.S.C. §§ 423(d)(5), 1382c(a)(3)(H)(i); 20 C.F.R. §§ 404.1512, 416.912. Once the claimant has satisfied his or her burden at steps one through four, it is incumbent upon the ALJ to show that jobs exist in the national economy that the claimant could perform and that are consistent with his or her age, education, work experience, and RFC. 20 C.F.R. §§ 404.1512(f), 416.912(f).
In this case, the ALJ found that Ainsworth met the insured status requirement under Title II of the Act through June 30, 2012. He then proceeded through steps one through five of the sequential evaluation process. Ultimately, the ALJ concluded that Ainsworth was not disabled at any time between May 1, 2009, his alleged onset date, and February 23, 2012, the date of his decision.
At step one of his evaluation, the ALJ found that Ainsworth had not engaged in any substantial gainful activity between May 1, 2009, and February 23, 2012. Tr. 15. At step two of his evaluation, the ALJ found that Ainsworth had medically determinable severe impairments consisting of patellofemoral degenerative joint disease of the right knee; status post right patella fracture; and disc protrusion at L4-5. Id. With respect to Ainsworth's decreased intellectual functioning and bipolar disorder, the ALJ found that such were unsupported by medical evidence of record, which failed to show significant complaints of, or treatment for, decreased intellectual functioning and bipolar disorder after May 1, 2009. Id. The ALJ concluded that these conditions did not cause any more than a minimal limitation on Ainsworth's ability to perform basic work tasks; therefore, he found that the decreased intellectual functioning and bipolar disorder were not severe. Id. Proceeding to step three of his analysis, the ALJ found that Ainsworth did not have an impairment or combination of impairments that met or medically equaled the severity of one of the listed impairments in 20 C.F.R. Part 404, Subpart P, Appendix 1. Tr . 16.
Prior to step four, the ALJ found that Ainsworth had the requisite RFC to perform light work, subject to the following additional limitations:
[S]itting 1 hour at a time for a total of 3 hours in an 8 hour workday; standing 1 hour at a time for a total of 2 hours in an 8 hour workday; walking 40 minutes at a time for a total of 3 hours in an 8 hour workday; must be able to use a cane to ambulate occasionally but is able to ambulate - of a mile without the use of a cane; occasional operation of foot controls bilaterally; not climbing stairs, ramps ladders, or scaffolds; no balancing, stooping, kneeling, crouching or crawling; occasional working in extreme cold or extreme heat; occasional working around dust, odors, fumes and pulmonary irritants; occasional working around vibrations; no working around wetness and humidity; no operating a motor vehicle; and no working around unprotected heights or moving mechanical parts.
Tr . 17; see also 20 C.F.R. §§ 404.1567(b), 416.1567(b)(defining "light work").
At step four of his analysis, the ALJ found that Ainsworth's current RFC precluded him from performing the physical and mental demands of his past relevant employment as a landscaper, laborer, and mechanic technician. Tr. 22, 190.
Finally, at step five of his analysis, the ALJ found that given Ainsworth's RFC, age, education, and work experience, there were jobs of significant number in the national economy that Ainsworth could perform. Tr. 22. The ALJ based his conclusion on the testimony of a VE that a younger individual with at least a high school education, who could communicate in English with the RFC discussed above could perform the representative occupations of: information clerk (DOT 237.367-018), with 1, 082 jobs in the local economy, 6, 800 jobs in the regional economy, and 166, 000 jobs in the national economy; and, cashier (parking lot, entertainment) (DOT 211.462-010) with 522 jobs in the local economy, 3, 200 jobs in the regional economy, and 68, 000 jobs in the national economy. Tr . 67-68.
III. FACTUAL BACKGROUND.
A. Physical Medical History.
The record establishes that from April 2010 to May 2011, Ainsworth was treated by Raymond E. Dahl, D.O. ("Dr. Dahl") and Michael R. Werner, M.D. ("Dr. Werner") from Orthopedic Institute of Pennsylvania ("OIP") for patellofemoral degenerative joint disease of the right knee. Tr . 256. Within that time frame, Ainsworth also saw Drs. Dahl and Werner for a right patella fracture. Tr . 343. The records establish that Dr. Dahl consistently opined that Ainsworth's symptoms would not improve with surgery. Tr . 256, 344. Dr. Dahl completed a check-box Employability Assessment Form, dated April 20, 2010, in which he assessed that Ainsworth was temporarily disabled less than 12 months beginning on April 20, 2010. Tr . 172-74. Dr. Dahl ordered an MRI of the right knee, which he reviewed with Ainsworth on May 5, 2010. Tr . 256. Dr. Dahl noted that Ainsworth's posture and gait were normal, but that his knee was tender, his right leg was neurovascularly intact with good sensation and good distal pulses, and there was no ligamentous laxity. Id . Ainsworth's MRI showed a medial plica and arthritic changes, involving the patellofemoral joint, but that there was no evidence of a meniscus tear. Id. Dr. Dahl diagnosed patellofemoral degenerative joint disease of the right knee, but did not feel that Ainsworth's symptoms would improve with knee arthroscopy and instead discussed Synvisc injections. Id.
In September 2010, Ainsworth saw his family physician Glen R. Daughtry, D.O. ("Dr. Daughtry") who observed that Ainsworth's chronic right knee pain was worsening and that he had decreased range of motion. Tr . 319. Dr. Daughtry further noted that Ainsworth had a chronic history of depression, which was ongoing and worsening, but that it was secondary to his chronic pain and inability to work. Id. Dr. Daughtry referred Ainsworth to OIP for evaluation and treatment. Id. On November 9, 2010, Dr. Dahl examined Ainsworth and noted that he exhibited normal posture and gait. Tr . 344. He also noted that Ainsworth had crepitus with range of motion; however, his right lower extremity was neurovascularly intact with good sensation and good distal pulses. Id. Dr. Dahl's impression was that there were no surgical options; he recommended pain management and placed Ainsworth in a lateral J brace. Id.
From about December 1, 2010 to September 22, 2011, Ainsworth treated with PRISM for pain management, at various times seeing Michael F. Lupinacci, M.D. ("Dr. Lupinacci"), William A. Pomilla, M.D. ("Dr. Pomilla"), and Rebecca Lingenfelter, PA-C ("Ms. Lingenfelter"). Tr . 370-382. Throughout this time period he was prescribed various narcotic pain medications such as, MS Contin, Gabapentin, a Lidoderm patch, Tramadol, and Neurontin. Id. On or about ...