United States District Court, M.D. Pennsylvania
MALACHY E. MANNION United States District Judge
above-captioned action is one seeking review of a decision of
the Acting Commissioner of Social Security
(“Commissioner”), denying Plaintiff Patrick
O'Toole's (“O'Toole”) application for
Social Security Disability Insurance Benefits
(“DIB”) and Supplemental Security Income
(“SSI”) under Title II and Title XVI,
respectively. For the reasons set forth below, the Court will
affirm the Commissioner's decision.
insurance benefits are paid to an individual if that
individual is disabled and “insured, ” that is,
the individual has worked long enough and paid social
security taxes. The last date that a claimant meets the
requirements of being insured is commonly referred to as the
“date last insured.” It is undisputed that
O'Toole met the insured status requirements of the Social
Security Act through March 31, 2013. (Tr. 13). In order to
establish entitlement to disability insurance benefits,
O'Toole was required to establish that he suffered from a
disability on or before that date. 42 U.S.C.
§423(a)(1)(A), (c)(1)(B); 20 C.F.R. §404.131(a);
see Matullo v. Bowen, 926 F.2d 240, 244 (3d Cir.
a federal income supplement program funded by general tax
revenues (not social security taxes). It is designed to help
aged, blind or other disabled individuals who have little or
no income. Insured status is irrelevant in determining a
claimant's eligibility for supplemental security income
protectively applied for DIB and SSI on April 3, 2013,
alleging disability beginning July 15, 2007, which he later
amended to December 20, 2012. (Tr. 11, 26, 146-57). His
claims were initially denied on August 21, 2013. (Tr. 90-97).
O'Toole requested a hearing before the Administrative Law
Judge (“ALJ”) Office of Disability and
Adjudication and Review of the Social Security
Administration, and one was held on November 7, 2014. (Tr.
23-63, 98-100). At the hearing, O'Toole was represented
by counsel, and a vocational expert testified. (Tr. 23-63).
On December 3, 2014, the ALJ issued a decision denying
O'Toole's applications. (Tr. 8-22). O'Toole filed
a request for review with the Appeals Council, which was
denied. (Tr. 1-5). Thus, the ALJ's decision stood as the
final decision of the Commissioner.
filed a complaint with this Court on August 10, 2016. (Doc.
1). The Commissioner filed an answer on October 13, 2016.
(Doc. 8). After supporting and opposing briefs were submitted
(Docs. 10, 11, 12), the appealbecame ripe for disposition.
appeals the ALJ's determination on three grounds: (1)
substantial evidence does not support the ALJ's step two
finding that some of his medical conditions were not severe;
(2) substantial evidence does not support the ALJ's
Residual Functional Capacity (“RFC”) assessment;
and (3) substantial evidence does not support the ALJ's
STANDARD OF REVIEW
considering a social security appeal, the Court has plenary
review of all legal issues decided by the Commissioner.
See Poulos v. Comm'r of Soc. Sec., 474 F.3d 88,
91 (3d Cir. 2007); Johnson v. Comm'r of Soc.
Sec., 529 F.3d 198, 200 (3d Cir. 2008). However, our
review of the Commissioner's findings of fact pursuant to
42 U.S.C. §405(g) is to determine whether those findings
are supported by “substantial evidence.”
Id. The factual findings of the Commissioner,
“if supported by substantial evidence, shall be
conclusive . . . .” 42 U.S.C. §405(g).
“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.” Johnson, 529 F.3d at
200 (3d Cir. 2008) (quoting Hartranft v. Apfel, 181
F.3d 358, 360 (3d Cir. 1999)) (internal quotations and
citations omitted). Substantial evidence has been described
as more than a mere scintilla of evidence but less than a
preponderance. Brown v. Bowen, 845 F.2d 1211, 1213
(3d Cir. 1988). “It means such relevant evidence as a
reasonable mind might accept as adequate to support a
conclusion.” Plummer v. Apfel, 186 F.3d 422,
427 (3d Cir. 1999) (citing Ventura v. Shalala, 55
F.3d 900, 901 (3d Cir. 1995)) (quoting Richardson v.
Perales, 402 U.S. 389, 401 (1971) (internal citations
omitted)). The United States Court of Appeals for the Third
Circuit has stated,
[O]ur decisions make clear that determination of the
existence vel non of substantial evidence is not
merely a quantitative exercise. A single piece of evidence
will not satisfy the substantiality test if the
[Commissioner] ignores, or fails to resolve, a conflict
created by countervailing evidence. Nor is evidence
substantial if it is overwhelmed by other evidence -
particularly certain types of evidence (e.g., that offered by
treating physicians) - or if it really constitutes not
evidence but mere conclusion.
Morales v. Apfel, 225 F.3d 310, 317 (3d Cir. 2000)
(citing Kent v. Schweiker, 710 F.2d 110, 114 (3d
Cir. 1983); Gilliland v. Heckler, 786 F.2d 178, 183
(3d Cir. 1986)). Therefore, a court reviewing the decision of
the Commissioner must scrutinize the record as a whole.
Id. (citing Smith v. Califano, 637 F.2d
968, 970 (3d Cir. 1981)).
SEQUENTIAL EVALUATION PROCESS
plaintiff must establish that there is some “medically
determinable basis for an impairment that prevents him from
engaging in any substantial gainful activity for a statutory
twelve-month period.” Fargnoli v. Massanari,
247 F.3d 34, 38-39 (3d Cir. 2001) (quoting Plummer,
186 F.3d at 427) (internal quotations omitted). “A
claimant is considered unable to engage in any substantial
gainful activity ‘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 . . . .' ” Fargnoli, 247 F.3d at
39 (quoting 42 U.S.C. §423(d)(2)(A)). The Commissioner
follows a five-step inquiry pursuant to 20 C.F.R.
§404.1520 to determine whether the claimant is disabled.
In Plummer, the Third Circuit set out the
In step one, the Commissioner must determine whether the
claimant is currently engaging in substantial gainful
activity. 20 C.F.R. §[404.]1520(a). If a claimant is
found to be engaged in substantial activity, the disability
claim will be denied. Bowen v. Yuckert, 482 U.S.
137, 140 (1987) . . . . In step two, the Commissioner must
determine whether the claimant is suffering from a severe
impairment. 20 C.F.R. §404.1520©. If the claimant
fails to show that her impairments are “severe, ”
she is ineligible for disability benefits. In step three, the
Commissioner compares the medical evidence of the
claimant's impairment to a list of impairments presumed
severe enough to preclude any gainful work. 20 C.F.R.
§404.1520(d). If a claimant does not suffer from a
listed impairment or its equivalent, the analysis proceeds to
steps four and five. Step four requires the ALJ to consider
whether the claimant retains the residual functional capacity
to perform her past relevant work. 20 C.F.R.
§404.1520(d). The claimant bears the burden of
demonstrating an inability to return to her past relevant
work. Adorno v. Shalala, 40 F.3d 43, 46 (3d Cir.
If the claimant is unable to resume her former occupation,
the evaluation moves to the final step. At this stage, the
burden of production shifts to the Commissioner, who must
demonstrate the claimant is capable of performing other
available work in order to deny a claim of disability. 20
C.F.R. §404.1520(f). The ALJ must show there are other
jobs existing in significant numbers in the national economy
which the claimant can perform, consistent with her medical
impairments, age, education, past work experience, and
residual functional capacity. The ALJ must analyze the
cumulative effect of all the claimant's impairments in
determining whether she is capable of performing work and is
not disabled. See 20 C.F.R. §404.1523. The ALJ
will often seek the assistance of a vocational expert at this
fifth step. See, [sic] Podedworny v.
Harris, 745 F.2d 210, 218 (3d Cir. 1984).
Plummer, 186 F.3d at 428.
was born on January 28, 1970, has a limited education, and is
able to communicate in English. (Tr. 18). In the past,
O'Toole worked as a machine feeder, commercial cleaner,
bakery helper, laborer stores, and as a kitchen helper. (Tr.
17-18). O'Toole has not engaged in substantial gainful
activity since the alleged amended onset date of disability,
December 12, 2012 (Tr. 13).
has a history of type 1 diabetes mellitus, chronic renal
insufficiency, and hyperlipidemia. (Tr. 726). He received
medical care for these conditions at Milton S. Hershey
Medical Center (“Hershey”). (Tr. 247-717,
726-975). Deborah Shepherd, MSN, CRNP, of Hershey's
Endocrinology Department, reported on December 4, 2012, that
O'Toole's diabetes improved with the help of a
dietician. (Tr. 644). This was an improvement since
O'Toole previously reported that he was sick of taking
care of his diabetes. (Tr. 645). Nurse Shepherd prescribed
management with Humalog, Insulin, and glucose tablets. (Tr.
December 20, 2012, O'Toole saw his primary care
physician, Munima Nasir, M.D. (Tr. 639-40). Dr. Nasir noted
that O'Toole had been “extremely poorly compliant
with his care, ” however, he “seem[ed] to be
doing better” since reestablishing endocrinological
care. (Tr. 639). Dr. Nasir noted his history of type 1
diabetes mellitus with diabetic nephropathy, neuropathy and
retinopathy. (Id.). O'Toole stated that he was
doing fairly well and denied acute issues. (Id.).
His physical examination was unremarkable and Dr. Nasir
recommended follow-up with Endocrinology. (Tr. 639-40).
January 14, 2013 nutrition outpatient note provides that
O'Toole is “very happy with how things have worked
since he is doing intense carb counting, ” and that he
“loves” his insulin pens. (Tr. 634). It was
further noted that he lives with his parents, is a
landscaper, and was advised to continue to complete food and
glucose records and to bring with him to his next appointment
on February 11, 2013. (Id.). His follow up nutrition
appointment in February again noted that he loves his insulin
pens, but that his glucose logs and food records were
incomplete and he has not been landscaping because he has
been ill and very tired. (Tr. 631).
had a consultation for chronic kidney disease with Christin
Spatz, M.D. on February 18, 2013. (Tr. 623). Dr. Spatz noted
that O'Toole has suffered from diabetes type 1 since the
age of 20. (Id.). She also indicated other medical
complications of nephropathy, retinopathy and neuropathy.
(Id.). His symptoms included fatigue, feeling cold,
left-sided pain and reduced appetite. (Id.). Dr.
Spatz noted that O'Toole had very poorly controlled
diabetes and was lost to follow-up with endocrinology due to
noncompliance, but that he has recently reestablished with
endocrinology and has continued to improve his blood sugar
control. (Id.). She also noted that he was
remarkable for hyperlipidemia, but does not currently take
his cholesterol medicine. (Id.). With regard to his
chronic kidney disease care, Dr. Spatz noted that his renal
function has remained stable for the last 3 years but that he
does have significant proteinuria, and explained to him the
importance of blood sugar control in preserving his renal
function. (Tr. 624).
March 8, 2013, O'Toole presented to the Hershey Medical
Center emergency room with complaints of nausea with vomiting
of dark emesis after arrival to the emergency room. (Tr.
606). A CT scan of his abdomen revealed no evidence of acute
intrathoracic, intra-abdominal, or intrapelvic pathology, but
greater than expected calcific atherosclerosis for his age.
(Tr. 607). O'Toole was discharged on March 10, 2013 with