United States District Court, M.D. Pennsylvania
MARTIN C. CARLSON, Magistrate Judge.
I. Statement of Facts and of the Case
When adjudicating social security appeals, an Administrative Law Judge (ALJ) typically must make three factual determinations, factual findings which in turn often define the legal outcome in a case. First, the ALJ must assess the credibility of the claimant. Second, the ALJ must determine the degree to which medical opinions accurately encapsulate the claimant's limitations. Third, the ALJ must develop a residual functional capacity assessment for the claimant which accurately embraces the impairments and limitations credibly experienced by the claimant. The ALJ performs these fact-finding tasks guided by regulations, regulatory guidance and case law, all of which describe the role of the ALJ in this process and define for the courts a deferential standard of review when evaluating these fact-bound determinations. We are reminded of these legal tenets in this case where we are asked to evaluate an Administrative Law Judge's (ALJ) decision denying social security disability benefits to the plaintiff, Cynthia Love. In this case, the ALJ's decision was made against a factual backdrop marked by conflicting evidence relating to the nature, severity and disabling effect of Ms. Love's medical conditions. Much of this evidence cast doubt upon the claimant's credibility and seemed to undermine this disability claim. Upon consideration of this evidence, for the reasons set forth below, we conclude that the ALJ's decision is supported by substantial evidence which is adequately explained on the record and, therefore, this decision will be affirmed.
B. Love's Medical and Employment History
On July 29, 2009, Cynthia Love applied for Social Security Disability Insurance Benefits ("DIB") under Title II, of the Social Security Act, alleging that she could no longer work any job in the national economy since January 25, 2009. (Tr. 123-29.) According to Love she had become disabled due to the cumulative effects of myalgia, myositis, plantar fascial fibromatosis, degenerative discs disease and carpal tunnel syndrome. (Tr. 13, 151.) At the time of the alleged onset of this disability, Love was 47 years old, which is defined as a younger individual, age-45-49, had a 9th grade education, and had a prior work history as a packager and bar attendant. (Tr. 16, 150-57.)
In presenting this claim of total disability, Love's credibility encountered an immediate obstacle: At her disability hearing, Love acknowledged collecting unemployment benefits, which are premised upon the claimant's assertion that she is able to work, at the same time that Love was insisting that she was totally disabled, and unable to pursue gainful activity. (Tr. 25.)
Love also came before the ALJ as an individual with a documented, longstanding opiate dependency. (Tr. 29-30.) Moreover, when questioned about this opiate use during her August 6, 2010, disability hearing, and specifically questioned concerning her past heroin use, Love provided inconsistent answers to the ALJ, first stating that she had not experimented with this narcotic drug for more than 20 years, and then acknowledging heroin use within the past three months. (Tr. 29-30.)
Love's medical records revealed that her use of opiates and other narcotics was a recurring theme, and concern, for her care givers. Thus, as early as January 2009, Love's physician was advising that "she should be able to take less hydrocodone." (Tr. 228.) Later, in October 2009, Love saw her treating physician, Dr. Hartman, (Tr. 295-96.), and reported "that her back was feeling good, but she did not want it to get bad." (Tr. 296.) Medical staff administered a urine screen to Love during this visit, (Tr. 296.), which tested positive for hyrdrocodone and mydromorphine, but negative for oxycodone. (Tr. 299.) As a result of this positive drug test, Love's physician reviewed their drug abuse policy with the plaintiff and instructed her regarding the treatment goals associated with long-acting opiates. (Tr. 298.) Two months later, in December 2009, Love began Suboxone treatment at the Shepherdstown Family Practice. (Tr. 311-22.) In the course of this treatment program, Love identified her drugs of choice as heroin or oxycontin, (Tr. 316.), stating that she used four to five packs of heroin a day, whenever she could obtain it, (Tr. 322.), and disclosing that she had used heroin three weeks prior to her treatment at Shepherdstown. (Id.)
As for Love's other underlying medical conditions, from 2009 through 2011, she was seen and treated by Dr. Stuart Hartman on numerous occasions. Dr. Hartman repeatedly documented unremarkable and benign findings during these physical examinations of Love. (Tr. 217, 222, 227, 331-32, 339-40, 343-44.) Thus, throughout 2009 and 2010, Dr. Hartman observed that Love's condition was "stable on [her] medications" (Tr. 218, 223, 228, 233, 238, 242, 245, 249, 295, 298, 301, 304, 306, 332, 336, 340.) Dr. Hartman also repeatedly opined in his treatment records that Love was "able to return to [her] normal occupation with minimal limitation" from January 2009 to May 2011. (Tr. 15, 217, 222, 227, 232, 237, 241, 245, 249, 294, 297, 300, 302, 305, 331, 339.)
Love's own reported activities of daily living also supported a finding that she had some capacity for gainful activity. While Love reported that she spent "90 percent" of the day sitting down, (Tr. 39.), Love also stated that she drove, vacuumed, washed dishes, did the laundry, cooked, shopped for groceries alone, took care of the family dog, and attended church weekly. (Tr. 35-6, 176-78.). In addition, Love testified that two weeks prior to the administrative hearing she traveled to the beach, which was approximately two and a half hours from her house, albeit with two breaks. (Tr. 34.)
It was against this backdrop that, on June 28, 2010, Dr. Hartman prepared a physical capacities evaluation for Love in connection with these disability proceedings. (Tr. 308-310.) For the most part, this evaluation revealed that Love retained the capacity for performing sedentary work. Thus, Dr. Hartman found that Love could lift 10 pounds; could engage in grasping, reaching, pulling, pushing and fine manipulation; and could occasionally bend, squat, stoop and carry. (Id.) Dr. Hartman also found that Love had the ability to drive, shop, travel without assistance, ambulate, climb stairs, and engage in a full array of activities of daily living. (Id.) Indeed, the only aspect of Dr. Hartman's evaluation which was at all problematic in terms of her continued employment in sedentary work was his notation that she could not operate foot controls, and his indication that she could only sit for a 4 hour period during the workday. (Tr. 308.)
C. The ALJ Hearing and Decision
Having received this equivocal and contradictory evidence regarding Love's physical condition, the ALJ conducted a hearing on August 6, 2010. (Tr. 21-54.) At this hearing, Love testified, providing contradictory accounts of her heroin use, admitting that she had lied to at least one physician in the past in order to obtain drugs, and giving an equivocal account of the degree to which her medical conditions were wholly disabling. (Tr. 26-45.) A vocational expert (VE) also testified. (Tr. 46-53.) In this VE testimony, the expert addressed a series of hypothetical questions posed by the ALJ, hypotheticals relating to a 48 year old, with a 9th grade education, who could sit for 6 hours a day, and stand or walk for one hour each workday, who was limited to lifting or carrying 10 pounds, had no limitations on hand and finger manipulation, but could bend and squat occasionally, and whose leg movements were restricted to occasional movements for the right leg but unlimited movement of the left leg. (Tr. 46.) Presented with this hypothetical, the VE opined that a person with this constellation of conditions could work at a number of sedentary occupations. (Tr. 47-48.) The VE conceded, however, that if this hypothetical worker could not sit, stand or walk for 8 hours a day, then she would be disabled. (Tr. 49-50.)
Following this hearing, on November 1, 2010, the ALJ issued his decision denying Love's application for benefits. (Tr. 8-20.) After reviewing the medical evidence, and Love's one contradictory accounts, the ALJ found that Love was not wholly credible in her descriptions of the degree and severity of her pain. The ALJ detailed the factual basis for this conclusion in the opinion, noting at length how Love's subjective complaints did not match objective medical testing, or the treatment records provided by her care givers. (Tr. 14-15.)
The ALJ further found that Love suffered from the following conditions that, while severe, did not meet any of the listing criteria which would qualify Love for benefits at step 3 of the five step Social Security disability assessment process: myalgia, myositis, plantar fascial fibromatosis, degenerative discs disease and carpal tunnel syndrome. (Tr. 13.) The ALJ then concluded that Love retained the ability to perform sedentary work, with the following limitations: Love could sit for 6 hours a day, and stand or walk for one hour each workday; was limited to lifting or carrying 10 pounds; had no limitations on hand and finger manipulation; could bend and squat occasionally; and Love's leg movements were restricted to occasional movements for the right leg but unlimited movement of the left leg. (Tr. 14.) For the most part this residual functional capacity assessment incorporated the limitations recommended by Dr. Hartman in his physical capacity assessment, (Tr. 308-310.), and was consistent with the objective medical records provided to the ALJ, records which consistently reported that Love was "able to return to [her] normal occupation with minimal limitation" from January 2009 to May 2011. (Tr. 15, 217, 222, 227, 232, 237, 241, 245, 249, 294, 297, 300, 302, 305, 331, 339.)
Where the ALJ did not adopt particular medical limitations described by Dr. Hartman, the ALJ articulated specific reasons for not doing so. For example, the ALJ explained that he did not limit Love to 4 hours sitting per day at work, because Love had testified that she currently was able to sit 90% of the day, testimony which suggested a greater tolerance for extended periods seated than that acknowledged by Dr. Hartman. (Tr. 16.) Similarly, the ALJ declined to adopt the full extent of the foot manipulation restrictions suggested by Dr. Hartman because the ALJ found that the doctor's opinion did not distinguish between right and left foot movements, a distinction that drew significant support from the record before the ALJ, which revealed that Dr. Hartman only documented significant findings with regard to Love's right foot and leg during physical examinations. (Tr. 305, 331-32, 335, 339-40, 343, 347.)
Having made these findings the ALJ then concluded at step 5 of the analytical process that Love could perform sedentary work. (Tr. 16.) Therefore, the ALJ found that Love was not disabled and denied her application for disability benefits. (Id.)
This appeal followed. (Doc. 1.) The parties have now fully briefed this matter, with the plaintiff arguing on appeal: (1) that the ALJ erred in finding that Love lacked credibility; (2) that the ALJ erred in failing to give appropriate weight to all of the physical limitations found by Love's treating physician; and (3) that the residual functional capacity (RFC) assessment of the ALJ was incomplete and erroneous because it did not fully incorporate all of Love's claimed medical limitations. (Docs. 9 and 11.) The Commissioner has responded to these arguments, (Doc. 10.), and this case is now ripe for resolution.
For the reasons set forth below we find that substantial evidence supports the ALJ findings in this case; that those findings are adequately explained on the record; and that the findings reflect an appropriate assessment of all of ...