United States District Court, M.D. Pennsylvania
MEMORANDUM TO DENY PLAINTIFF'S APPEAL Docs. 5, 6, 7, 8, 9
GERALD B. COHN, Magistrate Judge.
I. Procedural History
On February 26, 2010, Jack Leroy Black ("Plaintiff") filed an application for Title II Social Security Disability benefits ("DIB"), with an alleged onset date of February 1, 2010 (Tr. 90-91).
This application was denied, and on August 2, 2011, a hearing was held before an Administrative Law Judge ("ALJ"), where Plaintiff appeared with counsel and testified, as did a vocational expert (Tr. 23-34). On August 4, 2011, the ALJ issued a decision finding that Plaintiff was not entitled to DIB because Plaintiff could perform sedentary work, except that he may frequently balance, stoop, kneel, crouch, and crawl (Tr. 14). Plaintiff may occasionally climb stairs and may not climb ladders (Tr. 14). The ALJ further determined, based on VE testimony, that Plaintiff could perform his past relevant work as a bookkeeper and auditor (Tr. 19). On January 11, 2013, the Appeals Council denied Plaintiff's request for review, thereby affirming the decision of the ALJ as the "final decision" of the Commissioner. (Tr. 1-6).
On March 8, 2013, Plaintiff filed the above-captioned action pursuant to 42 U.S.C. § 405(g), to appeal a decision of the Commissioner of the Social Security Administration denying social security benefits. Doc. 1. On May 23, 2013, Commissioner filed an answer and administrative transcript of proceedings. Docs. 4, 5. In June, July, and August 2013, the parties filed briefs in support. Docs. 6, 7, 8. On May 1, 2014, the Court referred this case to the undersigned Magistrate Judge. On May 19, 2014, the parties consented to Magistrate Judge jurisdiction. Doc. 11.
II. Standard of Review
When reviewing the denial of disability benefits, we must determine whether the denial is supported by substantial evidence. Brown v. Bowen , 845 F.2d 1211, 1213 (3d Cir. 1988); Johnson v. Commissioner of Social Sec. , 529 F.3d 198, 200 (3d Cir. 2008). Substantial evidence "does not mean a large or considerable amount of evidence, but rather such relevant evidence as a reasonable mind might accept as adequate to support a conclusion." Pierce v. Underwood , 487 U.S. 552, 564 (1988); Hartranft v. Apfel , 181 F.3d 358, 360. (3d Cir. 1999); Johnson , 529 F.3d at 200.
This is a deferential standard of review. See Jones v. Barnhart , 364 F.3d 501, 503 (3d Cir. 2004). Substantial evidence is satisfied without a large quantity of evidence; it requires only "more than a mere scintilla" of evidence. Plummer v. Apfel , 186 F.3d 422, 427 (3d Cir. 1999). It may be less than a preponderance. Jones , 364 F.3d at 503. Thus, if a reasonable mind might accept the relevant evidence as adequate to support the conclusion reached by the Acting Commissioner, then the Acting Commissioner's determination is supported by substantial evidence and stands. Monsour Med. Ctr. v. Heckler , 806 F.2d 1185, 1190 (3d Cir. 1986).
To receive disability or supplemental security benefits, Plaintiff 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); 42 U.S.C. § 1382c(a)(3)(A).
Moreover, the Act requires further that a claimant for disability benefits must show that he has a physical or mental impairment of such a 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." 42 U.S.C. § 423(d)(2)(A); 42 U.S.C. § 1382c(a)(3)(B).
III. Relevant Facts in the Record
A. Plaintiff's Statements and Activities
Plaintiff is a fifty-four (54) year old male who alleges disability on or around February 1, 2010; he was fifty-one (51) years of age at the alleged date of onset.
During the relevant period, Plaintiff collected unemployment benefits, attesting to the Commonwealth of Pennsylvania that he was ready, willing, and able to work (Tr. 27). He handled his personal care, cooked, took out the trash, and drove a car (Tr. 27-28). Plaintiff testified that he had no problem sitting, could squat to bend down to pick up an object, and lift his arms over his head (Tr. 29). He testified that his prescribed medications helped him without side effects (Tr. 300).
Plaintiff alleged disability beginning February 1, 2010 (Tr. 116-25). However, his alleged onset date does not correspond to specific event, injury, or medical treatment date.
The ALJ concluded Plaintiff has the "severe" impairments of coronary artery disease, hypertension, venous stasis, bilateral edema, bilateral leg ulcers, and obesity, as defined in 20 C.F.R. 404.1520(c) and 416.920(c). (Tr. 12). Plaintiff is seventy-one (71) inches tall and four-hundred and thirty seven (437) pounds. As a result, Plaintiff's BMI at the date of onset was 60.9, indicating that Plaintiff suffers from morbid obesity, as acknowledged by the ALJ. (Tr. 14).
B. Relevant Medical Evidence
In January 2010, Plaintiff made two visits to his primary care physician for chronic leg edema, pain in his right lower extremity, and a skin infection (Tr. 182-85). On physical examination, Plaintiff was in no acute distress, albeit obese (Tr. 184). A review of Plaintiff's body systems was negative for fatigue, fever, night sweats, cough, dyspnea, wheezing, chest pain, and irregular heart beat/palpitations (Tr. 182).
Plaintiff was referred to the Pinnacle Health Wound Care for an ulcer on his right leg (Tr. 199-200). Plaintiff denied fever or chills (Tr. 199). He continued treatment for his right leg ulcer, as well as an ulcer that developed on his left leg (Tr. 199-226, 262-93, 311-74, 382-98, 400-28).
In March of 2010, Plaintiff saw Brijeshwar Maini, M.D., for cardiac evaluation (Tr. 193-94). A non-invasive work-up revealed diminished ankle-brachial indices bilaterally with evidence of severe infrainguinal disease (Tr. 193, 195). Dr. Maini recommended further diagnostic testing (Tr. 193). A cerebrovascular duplex study dated March 26, 2010, showed no significant stenosis of the right internal carotid artery (Tr. 190). The study showed mild stenosis of the left common carotid artery and mild stenosis in the left internal carotid artery (Tr. 190). Plaintiff had no significant stenosis in the left external carotid artery (Tr. 190). The only severe stenosis was in the right external carotid artery (Tr. 190). The study also showed antegrade flow in both vertebral arteries; heterogeneous plaque noted in the left common, bilateral external and bilateral internal carotid arteries; and mild to moderately elevated velocities in the proximal subclavian arteries bilaterally (Tr. 190). Dr. Maini recommended a follow-up study in one year (Tr. 190).
Dr. Maini also ordered a Transthoracic Echo Report for indications of chest pain, hypertension, and dyslipidemia (Tr. 191). The testing was noted to be of limited quality study due to poor acoustic windows (Tr. 191). The study, however, showed probable normal left ventricular size and function, left ventricular ejection fraction of sixty percent; right ventricle not well visualized, normal right ventricular size and function; and no significant valvular abnormalities (Tr. 191).
A May 12, 2010 Stress Echo showed abnormal dobutamine stress echocardiograph study (Tr. 307).
On May 24, 2010, Dr. Maini recommended a cardiac catherization and possible percuataneous revascularization (Tr. 250). Dr. Maini also recommended that Plaintiff work very diligently to lose weight (Tr. 250).
A June 1, 2010 chest study showed mild bibasilar atelectasis and no acute cardiopulmonary abnormality (Tr. 309).
On July 2, 2010, Dr. Maini recommended continued medication management (Tr. 254). He noted that there was a possibility that Plaintiff would not be considered for surgical revascularization because of his obesity (Tr. 253-54).
On July 21, 2010, Plaintiff saw John L. Pennock, M.D., concerning his coronary artery disease (Tr. 256). Plaintiff's main symptom was shortness of breath (Tr. 256). He denied angina (Tr. 256). A cardiac catherization showed multi-vessel coronary artery disease with 100% occlusion of the left anterior descending artery (LAD) filling by collaterals (Tr. 302). A long eighty percent stenosis of the mid to distal right coronary artery (Tr. 302). Plaintiff had low normal ejection fraction, fifty to fifty-five percent, with very mild anterior hypokinesis (Tr. 302). Dr. Pennock did not believe that Plaintiff was a candidate for bypass surgery due to LAD not being bypassable, and also because of Plaintiff's weight (Tr. 256). He recommended medication therapy (Tr. 256).
In October 2010, Dr. Maini noted that Plaintiff was stable from a cardiac standpoint (Tr. 376). Dr. Maini continued to recommend medical therapy (Tr. 376). Dr Maini also recommended that Plaintiff keep a close watch on his elevated blood pressure, and find a weight loss program, possibly a bariatric surgeon (Tr. 376-77).
By February 2011, Plaintiff's left calf wound had no tunneling or undermining (Tr. 373). There was a moderate amount of serious drainage noted, but the wound pain level was zero (Tr. 373). The wound margin was flat and intact (Tr. 373). There was seventy-six to one hundred percent slough within the wound bed, with no eschar or granulation present (Tr. 373). There was also no tunneling or undermining noted on the right calf wound (Tr. 373). There was no drainage noted (Tr. 373). The wound margin was attached to the wound base (Tr. 373). There was ...