United States District Court, M.D. Pennsylvania
Honorable Richard P. Conaboy United States District Court
consider here the appeal of Plaintiff John Irvin from an
adverse decision of the Social Security Administration
(“SSA”) or (“Agency”) regarding his
application for Disability Insurance Benefits
(“DIB”) and Supplemental Security Income
(“SSI”). Plaintiff's claims were initially
denied at the administrative level on July 11, 2013.
Plaintiff then requested a hearing before an administration
law judge (“ALJ”) and received one on April 8,
2015 before ALJ Michael F. Colligan. On May 20, 2015, the ALJ
issued a decision denying Plaintiff's applications for
benefits whereupon Plaintiff requested review by the Appeals
Council. On August 4, 2016, the Appeals Council affirmed the
ALJ's decision. Plaintiff has appealed to this Court
which enjoys jurisdiction over this matter pursuant to 42
U.S.C. § 405(g).
applications for DIB and SSI are predicated on his allegation
that he became disabled on March 6, 2013. Plaintiff claims
that his alleged disability is a result of a left shoulder
injury status post arthroscopy, left shoulder DJD, cervical
degenerative disc disease, asthma/COPD, Raynaud's
disease, urticaria, and bilateral basal arthritis of the
Testimony Before the ALJ.
April 8, 2015, Plaintiff testified before the ALJ. He was
accompanied by his attorney, Stephen J. Hogg. Also testifying
was a vocational expert (“VE”), Dr. Paul
Anderson. Plaintiff testified that he was 54 years of age on
the date of the hearing, that he was right-handed, that he
graduated from high school, that he served in the military,
and that he had training as a barber and held a license as a
barber manager. (R.at 30).
stated that he had briefly worked at two jobs after his
alleged onset date. He could not recall the identity of the
first employer but identified Amazon as the second employer.
The first job had been as a cashier at a truck stop. The job
at Amazon was work in a warehouse. Plaintiff stated that the
work at Amazon was full-time but that he was forced to quit
“when my thumbs came into play.” (R.31-21).
Before his alleged onset date Plaintiff stated that he had
worked as a self-employed barber and as a barber in shops
owned by others. Before that, Plaintiff worked for the
Pennsylvania Bureau of Worker's Compensation and the
Pennsylvania Liquor Control Board as a clerk doing general
office work. Even earlier in his career Plaintiff had worked
as a van driver transporting indigent persons to medical
appointments, school, and work. Plaintiff's work history
goes back to the mid 1980's. (R.32-33).
March of 2013, Plaintiff stopped working as a barber due to
pain in his left shoulder. At that time working for one day
would so exacerbate his left shoulder pain that he would need
to take several days off for the pain to subside. As of the
date of his hearing (April 8, 2015) Plaintiff described his
shoulder as “better than it was” but stated that
he still has pain. The pain is aggravated if he tries to
raise his arm to shoulder level. This makes it difficult to
work as a barber. He also testified to a problem with his
thumbs that began in the summer of 2014. The problem with his
thumbs required surgery which was helpful to some degree.
However, as of April 8, 2015, he still had difficulty
pinching or holding objects and has little power in his grip.
(R.33-35). Plaintiff also testified that he has been
asthmatic since he was a child and that, while his asthma is
always present, it is typically well-controlled by mediation
like Combivent and Symbicort. (R.36).
questioning by his attorney, Plaintiff explained that since
March of 2013 his problems with his thumb function would not
permit him to work as a barber full-time. These symptoms
included extreme stabbing pain at the base of his thumbs
that, once started, would persist for hours. Even more
problematic was his left shoulder and this was so even after
undergoing shoulder surgery in 2013. He also began
experiencing problems in his right shoulder at some
indeterminate time in 2013, but the right shoulder problem is
not as serious as that in his left shoulder. He estimated
that he cannot lift more than ten pounds overhead with his
left arm and that his right arm is somewhat stronger. He
stated also that he has more mobility in his right shoulder
than in his left. (R.37-41). Plaintiff then testified to neck
problems that he characterized as a “ratching
wrench” or a “popping”. He also stated that
he has a hard time turning his head and that when his neck
“pops” it produces pain that lasts for seconds.
He also stated that he still drives but finds it impossible
to wrap his thumbs around the wheel. He holds the bottom of
the steering wheel against his palms and exerts upward
pressure as needed to turn the wheel. (R.42).
also testified that he suffers from urticaria and
Raynaud's disease. Both these conditions result in a
discoloration of the hands caused by poor circulation. Wet or
cold weather aggravates both conditions. These conditions are
characterized by itching, swelling and hives. During the
winter Plaintiff states that these symptoms are a daily
occurrence. While these conditions have been present since
Plaintiff's alleged onset date, the Plaintiff was
initially diagnosed with these conditions in 1985 or 1986.
Plaintiff also experiences bilateral numbness in his hands
and feet as a result of his urticaria and Raynaud's
disease. These symptoms prevent his participation in
activities such as climbing a rope, archery, using a rifle,
and bicycling. His ability to handle things is also
compromised because his hands lack sensitivity. (R.42-45).
complaining that he is sometimes short of breath, Plaintiff
indicated that he could walk from one half mile to a mile
without becoming winded. He could not, however, provide any
estimate of his walking pace. He also stated that, after
walking about one mile, pain in his lower back begins to
describing a typical day since his alleged onset of
disability in March of 2013, Plaintiff stated: that he gets
up and makes coffee and something for breakfast; that he does
the laundry as needed but uses only his right hand to
complete that task; that his back pain limits his standing
and walking; and that after his shoulder surgery in September
of 2013, he was “pretty limited” for an
unspecified time. He stated further that when he worked in
the Amazon warehouse - -at a time after his alleged onset
date - -he was putting in ten hour days pushing carts that
weighed up to 450 pounds. This became difficult “after
a while” due to pain in his neck and back and the
problems with his thumbs. Plaintiff stated that he would no
longer be capable of doing the work he did at the Amazon work
testifying was Dr. Paul Anderson, a VE. Dr. Anderson
discussed the classifications of the jobs that Plaintiff had
performed in the past. He described Plaintiff's various
work experiences as light and skilled (barber); medium and
semi-skilled (van driver); and light and unskilled (cashier).
Dr. Anderson also responded to a hypothetical question from
the ALJ that asked him to assume an individual the same age
as the claimant and of the same educational level and work
history. He was asked to further assume that the individual
would be capable of light work in terms of exertion and would
have additional restrictions in that he would require an
air-conditioned work environment and one in which there would
be no exposure to temperature extremes or dust and fumes
beyond what would be expected in a well-maintained home or
office setting. Additional limitations would include: no
reaching above shoulder level with the left arm; and no
climbing involving ladders, ropes, or scaffolds. (R.50).
outlining the above-described hypothetical question, the ALJ
asked the VE whether jobs existed in the national economy
within the capacities stated in the hypothetical question.
The VE then stated that the hypothetical individual would be
capable of performing as a cashier, an information clerk, or
an usher. The VE added that the classifications he specified
for the various jobs that he mentioned were consistent with
publications of the United States Department of Labor
Plaintiff's counsel then asked the VE whether his opinion
of the hypothetical individual's ability to do the
various jobs he had identified would change if that
hypothetical individual was incapable of fingering, feeling,
and handling more than occasionally. The VE responded that,
given these additional limitations, all the jobs he had
identified would be precluded. (R.53).
Relevant Medical Evidence.
Dr. Keith Cordischi.
Cordischi treated Plaintiff at the Lebanon Veteran's
Hospital. In May of 2013, Dr. Cordischi saw Plaintiff for an
evaluation of his left shoulder. He indicated that an MRI of
Plaintiff's left shoulder revealed a large spinoglenoid
cyst, suprascapular nerve lesion, and loose bodies in the
shoulder joint. Dr. Cordischi noted also that Plaintiff
denied numbness or tingling but that he had pain with
overhead reaching maneuvers and could not maintain the left
shoulder in a static position, such as for cutting hair.
(R.370-71). Dr. Cordischi noted that Plaintiff was a
candidate for arthoscopic surgery of the left shoulder to
alleviate the aforementioned conditions. (R.371).
arthroscopic procedure was performed in September of 2013 and
Plaintiff experienced significant benefit from it. On October
30, 2013, Dr. Cordischi assessed that Plaintiff was doing
very well and had minimal pain referable to his left
shoulder. Dr. Cordischi stated: “The patient is doing
amazingly well given the extent of his injury and
surgery.” (R.575). In January of 2014, Dr. Cordischi
saw Plaintiff for a scheduled follow-up visit. The progress
notes of that visit indicate that Plaintiff continued to
progress and was “in very bright spirits and is very
motivated.” (R.572). In April of 2014, Dr. Cordishci
saw Plaintiff once again and authored progress notes
indicating: “The patient has done an outstanding job
rehabbing left shoulder and I emphasize to him the importance
of keeping up with his left shoulder home rotator
cuff/periscapular exercise program. I provided him with a
note today allowing him to return to full unrestricted duties
at work.... We agree that I will see him back on a p.r.n.
basis in the future, and that we have both been quite pleased
with the results of his surgery, given the extent of his
shoulder pathology.” (R.552).
6, 2014, the Plaintiff called the VA to report that he felt
like he re-injured the bicep that Dr. Cordischi had repaired.
This happened while he was exercising and felt a sudden
“pop” and experienced some slight pain. (R.540).
This incident prompted a return to Dr. Cordischi on July 28,
2014 incident to which Dr. Cordischi assessed left shoulder
pain and a possible biceps tendon rupture. (R>537). Dr.
Cordischi ordered an MRI of Plaintiff's left shoulder
which was performed on August 11, 2014. That MRI
demonstrated: (1) post operative changes in the left
shoulder; (2) tear of the supraspinatus tendon with probable
vertical split tear of the long head of the biceps tendon
anchor; and (3) a ganglion cyst in the subacromial region.
Dr. Daniel P. Healy, M.D.
August 8, 2014, Plaintiff saw Dr. Healy with complaints of
pain in both thumbs. The pain was concentrated at the base of
the thumbs. Dr. Healy's notes indicate that this
bilateral thumb pain affected Plaintiff's “power
pinch” and general ability to grip objects. Dr. Healy
read x-rays of Plaintiff's thumbs that he interpreted to
indicate basal joint arthritis involving both the basal and
scaphotrapezial joints in both thumbs. Dr. Healy's notes
reflect his plan to perform resection surgery at the basal
joint of both Plaintiff's thumbs. (R.583).
Healy performed a right thumb basal joint arthroplasty on
Plaintiff on September 2, 2014. (R.585). On October 15, 2014,
Dr. Healy observed that Plaintiff still lacked full mobility
in his right thumb and that he was experiencing minimal
tenderness on palpation. He stated that he would re-examine
Plaintiff in six weeks and that ...