United States District Court, M.D. Pennsylvania
Honorable Richard P. Conaboy, United States District Court.
We consider here the appeal of Plaintiff Donna Marie Laniewski (“Plaintiff” or “Laniewski”) from the decision of the Social Security Administration (“SSA”) denying application for Disability Insurance Benefits (“DIB”) and Supplemental Security Income Benefits (“SSI)”. The issues have been briefed by the parties (Docs. 21, 22, and 23) and are ripe for disposition.
A. Procedural Background.
In July of 2012, Plaintiff filed applications for DIB and SSI with the SSA. Plaintiff’s claims were denied at the administrative level on October 18, 2012. Plaintiff’s application was then considered by an administrative law judge (the “ALJ”) who conducted a hearing on the matter on August 6, 2013. The ALJ issued a decision denying benefits on August 20, 2013 whereupon the Plaintiff requested a review of that decision by the Appeals Council. The Appeals Council denied Plaintiff’s request on April 23, 2014 and thus rendered the ALJ’s decision the final decision of the agency. Plaintiff filed his appeal with this Court on August 14, 2014. The Court has jurisdiction over this appeal pursuant to 42 U.S.C. §§ 405(g) and 1383(c)(3).
B. Testimony Before the ALJ.
Plaintiff Laniewski testified as follows. She is a resident of Scranton, Pennsylvania. (Doc. 1, ¶ 5). She was born in 1963 and was 49 years old on the date of her hearing. (R.51). She alleges an onset date of January 1, 2009 for both her DIB and SSI claims. (R.45-47).
Plaintiff has a high school education and an associate’s degree in Human Services. (R.52). She last worked in November of 2012 as a home health aide for a mentally handicapped person. (R.53-54). From January of 2009 (her disability onset date) through November of 2012 she worked for both Allied Services and an organization called EIHAB supervising “high functioning” mentally handicapped persons who would visit Plaintiff in her home. (R.54). She essentially functioned as a sort of personal supervisor (Id.). Her role was simply to direct these persons in their daily activities regarding hygiene or their household finances. (R.56). Plaintiff’s earnings between 2009 and 2012 were insignificant. (R.54).
From 1984 through 2006, Plaintiff had worked for the Association of Retarded Citizens (“ARC”) as a program specialist in charge of three group homes. (R.57). In her capacity as a program specialist she would supervise other workers to insure that the clients attended their medical appointments and have “all that they needed.” (R.57). Her work as a program specialist with ARC involved traveling to different group homes but did not require her to do anything of a physical nature in terms of restraining the clients. (Id.). Her employment with ARC ended in 2006 when she was terminated after a “tiff” with her superior. (R.59-60).
From the time Plaintiff stopped working for ARC through 2010 she worked for indeterminate periods of time at the previously described positions with Allied Services and EIHAB and also in a more physically demanding job as a health aide at Moses Taylor Hospital for approximately one month. (R.60-61). Some of this work postdated her alleged onset date but was sporadic and did not result in significant earnings. (R.61).
Testimony was also taken from Joe Keating, a vocational expert. Mr. Keating was asked to respond to a series of hypothetical questions posed by the ALJ. The first of these hypothetical questions asked Mr. Keating to assume a person the same age as the Plaintiff with similar education and work experience who could: (1) occasionally lift and carry up to 20 pounds and frequently lift and carry up to 10 pounds; (2) stand/walk for up to six hours in an eight hour work day; (3) sit for at least six hours in an eight hour work day; (4) occasionally kneel, crouch, crawl, balance, and stoop; (5) occasionally use ramps and climb stairs; (6) never climb on ladders, ropes, or scaffolds; (7) occasionally use her right leg for pushing and pulling such as in the operation of foot pedals or controls; (8) never be exposed to slippery conditions or moving machinery; and (9) perform unskilled work involving simple routine tasks. Given these limitations, Mr. Keating testified that Plaintiff could not perform any of her past relevant work. (R.76-77). Mr. Keating testified that, assuming the limitations imposed by the ALJ’s first hypothetical question, Plaintiff could perform jobs available in the northeastern Pennsylvania region such as housekeeper, tagger, or packer. Mr. Keating stated that each of these jobs would be classified as “light-unskilled”. (R.77).
Mr. Keating next responded to a revised hypothetical question that assumed all limitations of the first hypothetical with these modifications: (1) the ability to lift/carry no more than 10 pounds; and (2) the ability to stand/walk no more than two hours in an eight hour work day. On the basis of these revisions, Mr. Keating testified that such an individual would be capable of performing sedentary level work as a surveillance monitor or assembler of small products.
The ALJ’s third and final hypothetical question asked the vocational expert to assume additional limitations including: (1) that the individual’s pain coupled with potential side effects of her medication and bouts of depression would cause her to be off task up to 20 percent of the time; and (2) that the individual would miss work entirely or be unable to complete her shift two or more days each month. The vocational expert responded that these additional limitations would render an individual incapable of any substantial gainful employment. (R.78).
C. Physical and Mental Impairment Evidence.
The medical evidence establishes that Plaintiff has treated for cervical radiculopathy, lumbar disc disease, anxiety, depression, chronic pain, bi-lateral leg pain with radiculopathy and shooting pain down her right leg, neuropathy, and herniated disc at L4-L5. The treatment for these conditions was provided by several different physicians. Her treatment history with these physicians is catalogued below as is the evaluations of her conditions rendered by several consulting physicians.
1. Dr. Paul Horchos.
The record disclosed that Plaintiff treated extensively with Dr. Paul Horchos from January of 2004 to November of 2008. Dr. Horchos saw Plaintiff initially on January 7, 2004. His office notes of that visit reflect an EMG/Nerve Conduction Study performed on July 19, 2003 which revealed a C5-C6 radiculopathy. His examination of that date revealed that Plaintiff was experiencing muscular spasm over her left shoulder and left occipital region as well as numbness and tingling from the left elbow to the left thumb. Dr. Horchos’ impression at that time was that Plaintiff suffered from a likely cervical disc herniation at C4-C5, C3-C4 level and left occipital neuralgia. (R.300-301).
Dr. Horchos next saw Plaintiff on January 22, 2004. His office notes on that occasion reflect an MRI scan of January 13, 2004 that revealed a cervical disc protrusion at C6-C7 with the electrophysiological evidence of C6 radiculopathy. (R.291). Dr. Horchos ordered an epidural steroid injection using a left C6-C7 transforaminal approach for muscular spasm relief.
On March 4, 2004, Dr. Horchos saw Plaintiff in follow-up to the aforementioned transforaminal epidural steroid injection “which really hasn’t seemed to make much effect on her overall condition.” In light of Plaintiff’s EMG Nerve Conduction Study, Dr. Horchos considered a repeat epidural injection. He decided, however, to prescribe physical therapy with cervical traction first.
Plaintiff returned to Dr. Horchos on April 2, 2004 complaining of right shoulder, neck, and arm pain which had been present for four to six weeks. Dr. Horchos noted that cervical traction seemed to ease her pain which “subjectively and objectively” radiated down Plaintiff’s right arm toward her thumb along the lateral border of the right forearm and hand. Dr. Horchos diagnosed cervicalgia with possible cervical disc herniation at C6 level. Dr. Horchos prescribed Neurontin to be taken in combination with oral steroids that had been prescribed by another physician. (R.288-289).
Dr. Horchos next examined Plaintiff on April 21, 2004. She stated at that time that the Neurontin was helpful in reducing the radicular pain in her right arm. Dr. Horchos discontinued the Neurontin at this time and directed Plaintiff to take a low dose of Hydrocodone two to three times a day. Dr. Horchos noted that, while Plaintiff’s pain had lessened, she was looking forward to an epidural steroid injection that she was about to have. Dr. Horchos’ impression continued to be right C6 radiculitis, with right rotator cuff tendinitis, and AC joint dispution. (R.286-87).
On May 12, 2004, Dr. Horchos again saw the Plaintiff. At that time, he noted a significant improvement in Plaintiff’s pain level as a result of a right cervical epidural steroid injection. Dr. Horchos stated “I am encouraged that her function is improving but I am not 100% positive that it is going to remain this ...